https://scholars.lib.ntu.edu.tw/handle/123456789/481086
標題: | Nonintubated needlescopic video-assisted thoracic surgery for management of peripheral lung nodules | 作者: | Tseng, Yu-Ding YA-JUNG CHENG MING-HUI HUNG KE-CHENG CHEN JIN-SHING CHEN |
公開日期: | 2012 | 卷: | 93 | 期: | 4 | 起(迄)頁: | 1049-1054 | 來源出版物: | Annals of Thoracic Surgery | 摘要: | Background: Video-assisted thoracic operations are usually performed with 5-mm or 10-mm instruments under general anesthesia with single-lung ventilation. Management of peripheral lung nodules by a needlescopic video-assisted thoracoscopic operation, without endotracheal intubation, has rarely been attempted. We evaluated the feasibility and safety of this minimally invasive technique in managing peripheral lung nodules. Methods: From August 2009 through March 2011, 46 patients with peripheral lung nodules were treated using 3-mm needlescopic video-assisted thoracoscopic operations for wedge resection with epidural anesthesia and sedation, without endotracheal intubation. Results: A definitive diagnosis was obtained in all 46. Extension of the 3-mm incisions was required in 8 patients because of primary lung cancer requiring a lobectomy in 3, pleural adhesions in 3, and difficulty in identifying or resecting the nodule in 2. Two patients required conversion to intubated single-lung ventilation because of dense adhesions between the lungs and the diaphragm. Operations lasted a mean of 69.2 ± 46.8 minutes. Postoperative side effects occurred in 4 patients, including sore throat, headache, and vomiting requiring medication. Operative complications developed in 1 patient who had air leaks for more than 3 days postoperatively. The mean postoperative chest tube drainage and hospital stay were 1.1 days and 2.7 days, respectively. Postoperative neuralgia was noted in 12 patients (26%). Most patients (74%) were very satisfied or satisfied with the resulting scars. Conclusions: Nonintubated needlescopic video-assisted thoracoscopic operations are technically feasible and safe and may be a less invasive alternative in the management of selected patients with peripheral pulmonary nodules. ? 2012 The Society of Thoracic Surgeons. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-84859026618&doi=10.1016%2fj.athoracsur.2012.01.062&partnerID=40&md5=f94a80cf6118a024e246a10808d9087b https://scholars.lib.ntu.edu.tw/handle/123456789/481086 |
ISSN: | 0003-4975 | DOI: | 10.1016/j.athoracsur.2012.01.062 | SDG/關鍵字: | adult; aged; air leak; article; clinical article; endotracheal intubation; epidural anesthesia; feasibility study; female; headache; hospitalization; human; lobectomy; lung cancer; lung ventilation; male; needlescopic video assisted thoracoscopic surgery; neuralgia; operation duration; patient satisfaction; peripheral lung lesion; pleura adhesion; postoperative complication; priority journal; safety; sore throat; thorax drainage; video assisted thoracoscopic surgery; vomiting; wedge resection; Adult; Aged; Female; Humans; Intubation, Intratracheal; Lung Diseases; Male; Middle Aged; Needles; Solitary Pulmonary Nodule; Thoracic Surgery, Video-Assisted; Young Adult |
顯示於: | 醫學系 |
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