https://scholars.lib.ntu.edu.tw/handle/123456789/561891
標題: | Nonintubated thoracoscopic anatomical segmentectomy for lung tumors | 作者: | MING-HUI HUNG HSAO-HSUN HSU KE-CHENG CHEN KUANG-CHENG CHAN YA-JUNG CHENG JIN-SHING CHEN |
公開日期: | 2013 | 出版社: | Elsevier USA | 卷: | 96 | 期: | 4 | 起(迄)頁: | 1209-1215 | 來源出版物: | Annals of Thoracic Surgery | 摘要: | Background Intubated general anesthesia with one-lung ventilation is considered mandatory for anatomical pulmonary resections. Nonintubated thoracoscopic segmentectomy for management of lung tumors, which is technically challenging, has not been reported previously. The goal of this study was to evaluate the feasibility and safety of thoracoscopic anatomical segmentectomy without endotracheal intubation. Methods From August 2009 to December 2012, 21 patients with lung tumors were treated using thoracoscopic anatomical segmentectomy without endotracheal intubation using a combination of thoracic epidural anesthesia, intrathoracic vagal blockade, and target-controlled sedation. Results There were 16 patients with primary or metastatic lung cancers and 5 patients with nonmalignant tumors. Left upper lobe apical trisegmentectomy was most commonly performed (n = 6), followed by superior segmentectomy of the right lower lobe (n = 4) and left lower lobe (n = 4). One patient required conversion to intubated single-lung ventilation because of vigorous mediastinal and diaphragmatic movement. No patient required conversion to a thoracotomy or lobectomy. Operative complications developed in 1 patient who had an air leak for more than 3 days postoperatively. The mean duration of postoperative chest tube drainage and mean hospital stay were 2.5 days and 6.0 days, respectively. Anesthetic induction and the operation required a mean 26.5 minutes and 148.0 minutes, respectively. Conclusions Nonintubated thoracoscopic segmentectomy is technically feasible and safe. It can be an alternative to intubated single-lung ventilation for management of lung tumors in selected patients. ? 2013 The Society of Thoracic Surgeons. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-84885321669&doi=10.1016%2fj.athoracsur.2013.05.065&partnerID=40&md5=3df15987f56f2dcfb58d2637a2d1b8da https://scholars.lib.ntu.edu.tw/handle/123456789/561891 |
ISSN: | 0003-4975 | DOI: | 10.1016/j.athoracsur.2013.05.065 | SDG/關鍵字: | adenoma; adult; aged; anesthesia induction; article; aspergilloma; body mass; cancer patient; cancer surgery; cardiopulmonary function; chest tube; clinical article; diaphragm movement; endotracheal intubation; female; forced expiratory volume; forced vital capacity; hamartoma; headache; histiocytoma; human; length of stay; lung cancer; lung function; lung non small cell cancer; lung tumor; lung ventilation; male; marginal zone lymphoma; metastasis; organizing pneumonia; patient safety; priority journal; sedation; sore throat; surgical technique; thoracoscopic anatomical segmentectomy; thorax drainage; thorax epidural anesthesia; thorax surgery; vomiting; 10; Adult; Aged; Aged, 80 and over; Anesthesia, Epidural; Autonomic Nerve Block; Carcinoma, Non-Small-Cell Lung; Deep Sedation; Feasibility Studies; Female; Humans; Intubation, Intratracheal; Lung Diseases; Lung Neoplasms; Lymphoma, B-Cell, Marginal Zone; Male; Mastectomy, Segmental; Middle Aged; Thoracoscopy; Treatment Outcome |
顯示於: | 醫學系 |
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