Non-intubated single-incision video-assisted thoracic surgery: A two-center cohort of 188 patients
Journal
Journal of Thoracic Disease
Journal Volume
9
Journal Issue
8
Pages
2587-2598
Date Issued
2017
Author(s)
Galvez C.
Navarro-Martinez J.
Bolufer S.
Abstract
Background: Non-intubated single-incision procedures are slowly expanding because of high experience and skill required, and stricter selection criteria. The aim of this study is to present the first retrospective two-center series in Taiwan and Spain. Methods: We performed a retrospective analysis of 188 patients undergoing non-intubated single-incision video-assisted thoracic surgery (NI-SI-VATS) procedures between July 2013 to November 2015 in two centers in Taiwan (170 patients) and Spain (18 patients) with two different anesthetic methods. Demographic data, clinicopathological features, preoperative tests, and final outcomes were analyzed to compare the outcomes with the two different techniques. Results: Of the 188 patients, 147 (78%) were women, with a mean body mass index (BMI) of 22.7. Of the 196 specimens, 145 (74%) were malignancies with a mean size of 9.7 mm. Wedge resection was performed in 172 patients (91.4%), anatomical segmentectomy with lymphadenectomy in 8 (4.7%), and lobectomy with lymphadenectomy in 5 (2.6%). Three patients (1.6%) required conversion to orotracheal intubation, while 5 patients (2.7%) required additional ports. Complications appeared in 16 patients (8.5%) with air leak as the most frequent in 7 cases (3.7%). Median chest drainage was 1 day, and median postoperative stay was 3 days. There was neither perioperative death nor postoperative readmission. Conclusions: Non-intubated single-incision procedures can be feasible and safe in expert hands and experienced teams, even for anatomical resections. Strict selection criteria, skill and experience are mandatory. Comparative cohorts and randomized trials are needed. ? Journal of Thoracic Disease.
SDGs
Other Subjects
adult; aged; air leak; Article; atelectasis; body mass; clinical effectiveness; clinical feature; cohort analysis; death; endotracheal intubation; feasibility study; female; hospital readmission; human; lobectomy; lymph node dissection; major clinical study; male; middle aged; non intubated single incision video assisted thoracic surgery; pancytopenia; patient safety; perioperative period; pneumonia; pneumothorax; postoperative complication; postoperative hemorrhage; postoperative period; preoperative period; retrospective study; segmentectomy; Spain; Taiwan; thorax drainage; treatment outcome; tumor volume; video assisted thoracoscopic surgery; wedge resection
Publisher
AME Publishing Company
Type
journal article