Single-port thoracoscopic lobectomy in a nonintubated patient: the least invasive procedure for major lung resection?

González-Rivas, Diego; Fernández, Ricardo; Torre, Mercedes de la; Rodríguez, José Luis Ramos; Fontan, Lara; Molina, Fernando

doi:10.1093/icvts/ivu209

Cited by 82 publications

(68 citation statements)

References 13 publications

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“…Non-intubated video-assisted thoracic surgery (NI-VATS) has evolved significantly in the last decade (1)(2)(3). Thoracic surgeons seek for a less invasive approach and developed single-incision VATS (also called uniportal VATS) and modifications, trying to decrease postoperative pain compared to multiportal VATS.…”

Section: Introductionmentioning

confidence: 99%

Non-intubated single-incision video-assisted thoracic surgery: a two-center cohort of 188 patients

et al. 2017

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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.

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Section: Introductionmentioning

confidence: 99%

Non-intubated single-incision video-assisted thoracic surgery: a two-center cohort of 188 patients

et al. 2017

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“…The major lung resection with radical lymphadenectomy for non-small cell lung cancer, was the first report by Dr. Gonzalez Rivas from Coruña University hospital in Spain, followed by complex uniportal VATS lung resection including lobectomy (4), pneumonectomy (5), segmentectomy (6), bronchoplastic procedures, chest Wall resection and a lobectomy in a non-intubated patient (7)(8)(9).…”

Section: Introductionmentioning

confidence: 99%

Uniportal video-assisted thoracoscopic surgery, Argentinian experience

Bondulich¹,

Rivas²

2017

J. Vis. Surg.

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The acceptance of uniportal video-assisted thoracoscopic surgery (VATS) for minor and major thoracic procedures is growing in South America. This study presents the experience with uniportal VATS in Buenos Aires, Argentina. In a retrospective study, 181 patients were operated with uniportal VATS technique between December 2013 and October 2016. Uniportal procedures included minor and major procedures.Uniportal VATS were analyzed en terms of morbidity, mortality, conversion rate, hospital stay. A total of 181 patients were analyzed. 59% were males and 41% females. The mean age was 58.

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“…Local intercostal infiltration was used without the vagal blockade, and the patient was discharged 36 hours postoperatively (24). The same group also subsequently reported their preliminary experience of uniportal nonintubated major pulmonary resection with promising results.…”

Section: Current Evidence Of Nits For Thoracic Proceduresmentioning

confidence: 98%

“…However, major procedures warrant sophisticated anaesthesia techniques. TEA blocking T2-T10 can induce long-lasting bilateral anaesthetic effects on the chest wall and pleural cavities, although the bronchial tone and airway hyper-reactivity may increase (24). In contrast, a paravertebral blockade through a T4-T5 level that blocks the sympathetic system unilaterally can offer pain relief like TEA but with fewer side effects (25).…”

Section: Anaesthetic Setting In Nitsmentioning

confidence: 99%

Anaesthesiology for uniportal VATS: double lumen, single lumen and tubeless

Zhao

Lau

2017

J. Vis. Surg.

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Abstract:The advent of one-lung ventilation (OLV) technique provides immobilized surgical field which is fundamental in minimally invasive thoracic surgery. Mainstem methods of achieving lung separation are either via a double-lumen endotracheal tube or placing a bronchial blocker (BB) through a single-lumen endotracheal tube. More recently, the use of non-intubated thoracic surgery (NITS) has been investigated intensively, attempting to minimise the complications that follow general anaesthesia. The aim of this review is to describe the mechanism of these techniques briefly and outlines the advantages and drawbacks of them with the comparison.

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Single-port thoracoscopic lobectomy in a nonintubated patient: the least invasive procedure for major lung resection?

Abstract: Single-port video-assisted thoracoscopic lobectomy in nonintubated patients seems to be feasible and safe, and probably represents the least invasive approach to lobectomy. Further studies are necessary to evaluate the results with a series of patients.

Cited by 82 publications

References 13 publications

Non-intubated single-incision video-assisted thoracic surgery: a two-center cohort of 188 patients

Non-intubated single-incision video-assisted thoracic surgery: a two-center cohort of 188 patients

Uniportal video-assisted thoracoscopic surgery, Argentinian experience

Anaesthesiology for uniportal VATS: double lumen, single lumen and tubeless

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