Non-intubated Minimally Invasive Chest Wall Stabilization for Multiple Rib Fractures: a Prospective, Single-arm Study

Abstract

Background Non-intubated video-assisted thoracoscopic surgery has been widely reported in the past decade while non-intubated chest wall stabilization has not been reported previously. The aim of this study was to evaluate the safety and feasibility of non-intubated minimally invasive chest wall stabilization in patients with multiple rib fractures. Methods We conducted a prospective, single-arm, observational study. In this prospective study, 20 consecutive patients with multiple rib fractures were treated using non-intubated minimally invasive chest wall stabilization. Results Minimally invasive chest wall stabilization were mostly performed for lateral rib fractures in this study (n = 8). The mean operation time was 92.5 minutes and mean blood loss was 49 ml. No patient required conversion to tracheal intubation. The mean extubation of laryngeal mask time was 8.9 minutes, mean postoperative fasting time was 6.1 hours, mean postoperative hospital stay was 6.2 days, mean postoperative drainage was 97.5 ml, mean postoperative pain score was 2.9 points at 6 hours, 2.8 points at 12 hours, and 3.0 points at 24 hours, mean postoperative nausea and vomiting score was 1.9 points at 6 hours, 1.8 points at 12 hours, and 1.7 points at 24 hours. Conclusions Non-intubated minimally invasive chest wall stabilization is safe and feasible in carefully selected patients. Further study with large sample size is warranted.