Awake anaesthesia for major thoracic surgical procedures: an observational study

Al-Abdullatief, Mohammad; Wahood, Abdulrazzak; Al-Shirawi, Nehad; Arabi, Yaseen M.; Wahba, Mohammed; Aljumah, Mohammed; Al-Sheha, Saud; Yamani, Nizar

doi:10.1016/j.ejcts.2007.04.029

Cited by 109 publications

(74 citation statements)

References 17 publications

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“…[1] uyanık VYTC ile yaptıkları 25 timektomi, 11 akciğer rezeksiyonu ve sekiz sempatektomi olgusunu içeren çalışmalarında; ortalama ameliyat süresinin 72 dakika (dağılım 55-100 dakika), ortalama hastanede kalış süresinin 1.5 gün olduğunu ve olguların %33'ünün aynı gün taburcu edildiğini bildirmişlerdir. Pompeo ve ark.nın [2] yapmış oldukları randomize kontrollü çalışmada ise uyanık VYTC uygulanan PSP'li olguların hastanede kalış sürelerinin genel anestezi uygulanan olgulara kıyasla anlamlı şekilde kısaldığı ve daha maliyet etkin olduğu sonucuna varılmıştır.…”

Section: Discussionunclassified

Awake video-assisted thoracoscopic bullectomy and pleural abrasion

Yanık¹

2017

Turk Gogus Kalp Dama

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Section: Discussionunclassified

Awake video-assisted thoracoscopic bullectomy and pleural abrasion

Yanık¹

2017

Turk Gogus Kalp Dama

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“…In general, there is a just limited experience on surgical management of mediastinal masses with local or locoregional anesthesia (19,20). A technique of anterior video-assisted mediastinotomy under local anesthesia has been reported (21) some years ago.…”

Section: Discussionmentioning

confidence: 99%

Minimalist video-assisted thoracic surgery biopsy of mediastinal tumors

et al. 2016

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Background: Mediastinal tumors often require surgical biopsy to achieve a precise and rapid diagnosis.However, subjects with mediastinal tumors may be unfit for general anesthesia, particularly when compression of major vessels or airways does occur. We tested the applicability in this setting of a minimalist (M) uniportal, video-assisted thoracic surgery (VATS) strategy carried out under locoregional anesthesia in awake patients (MVATS). Methods: We analyzed in a comparative fashion including propensity score matching, data from a prospectively collected database of patients who were offered surgical biopsy for mediastinal tumors through either MVATS or standard VATS. Tested outcome measures included feasibility, diagnostic yield, and morbidity. Results: A total of 24 procedures were performed through MVATS. Diagnostic yield was 100%. Median hospital stay and time interval to oncologic treatment were 2 days (IQR, 2-3 days) and 7 days (IQR, 5.5-11.5 days), respectively. At overall comparison (MVATS, N=24 vs. VATS, N=23), there was a significant difference in both frequency and severity of postoperative complication as measured by Clavien-Dindo classification (P<0.006). In a propensity score matched comparison (8 patients per group), grade 3 or 4 complications requiring aggressive management were found only in the general anesthesia group. Global time spent in the operating room was shorter in the MVATS group (P=0.05). Time interval to oncological treatment was the same between groups. Other differences were also found in SIRS score (P=0.05) and PaO 2 /FiO 2 (P=0.04) thus suggesting better adaption to perioperative stress. Conclusions: MVATS biopsy appears to be a reliable tool to optimize diagnostic assessment in patients with mediastinal tumors. It can offer high diagnostic accuracy due to large tissue samples, while reducing morbidity rate compared to the same operation under general anesthesia. More robust evaluation is needed to define the appropriateness of MVATS in this specific clinical setting.

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“…The use of NITOS to carry out videothoracoscopic anatomical lung resection for NSCLC is much more recent [43,[53][54][55], even though occasional reports of major surgeries performed with regional anesthesia alone can be found in the historical surgical literature [56][57][58]. The National Taiwan University group must be credited for the introduction and development of this pioneering thoracic surgery field.…”

Section: Non-small Cell Lung Cancermentioning

confidence: 99%