Tubeless video-assisted thoracic surgery for pulmonary ground-glass nodules: expert consensus and protocol (Guangzhou)

He, Jianxing; Liang, Hengrui; Wang, Wei; Akopov, Andrey; Aiolfi, Alberto; Ang, Keng‐Leong; Bertolaccini, Luca; Cai, Kaican; Cao, Qingdong; Chen, Baojun; Chen, Chang; Chen, Chun; Chen, Donglai; Chen, Fengxia; Chen, Jun; Chen, Lei; Chen, Mingwu; Chen, Yongbing; Chen, Zhuxing; Cheng, Chao; Dong, Cheng; Cui, Fei; Dai, Tianyang; Dong, Qi; Ferrari, Paolo Albino; Flores, Raja M.; Fu, Junke; Funaki, Soichiro; Froudarakis, Marios; Gan, Xiangfeng; Geng, Meiyu; Guo, Jialong; Guo, Qiang; Han, Yongtao; He, Jintao; He, Kaiming; Hirai, Kyoji; Hu, Jian; Hu, Shuqiao; Huang, Jian; Huang, Jun; Jiang, Wenfa; Kim, Kyung Soo; Kiss, Gábor Dávid; Kong, Fanyi; Lan, Lan; Leng, Xuefeng; Li, Bin; Li, Gaofeng; Li, Hecheng; Li, Hefei; Li, Heng; Li, Jiwei; Li, Xiaoqiang; Li, Shuben; Li, Yinfen; Li, Zhuoyi; Liang, Yi; Liang, Lixia; Liang, Wenhua; Liao, Yongde; Lin, Wanli; Xu, Lin; Liu, Hongxu; Liu, Hui; Liu, Jixian; Liu, Jun; Liu, Xiang; Liu, Zihao; Lu, Xingzhao; Luo, Qingquan; Mao, Naiquan; Pan, Qi; Pang, Dan; Peng, Jun; Pompeo, Eugenio; Rulin, Qian; Qiao, Kun; Redwan, Bassam; Sang, Zi; Shao, Wenlong; Shen, Jianfei; Shen, Weiyu; Sung, Sook-Whan; Tang, Wen‐Fang; Wang, Tianhu; Wang, Guangsuo; Wang, Haitao; Wang, Huien; Wang, Jiyong; Wang, Wen; Wang, Yongyong; Wang, Zhenyuan; Li, Wei; Wei, Wei; Wu, Hao; Wu, Jie; Xia, Zhaohua; Xu, Chenyang; Xu, Enwu; Xu, Hai; Xu, Ning; Xu, Quan; Xu, Rui‐hua; Xu, Shun; Yang, Chaokun; Yang, Hanyu; Yang, Shuai; Yi, Jun; Zhang, Guangjian; Zhang, Hao; Jia, Zhang; Zhang, Man; Xiao, Zhijian; Zhang, Yajie; Zhang, Zhe; Zhang, Zhifeng; Zhao, Hongwei; Zhao, Jian; Zhao, Xiaodong; Zhou, Jianping; Zhou, Yubo; Zhu, Chengchu; Zhu, Shaojin; Zhu, Xinhai; Cui, Jian; Yan, Yubo; Chen, Ke-Neng

doi:10.21037/tlcr-21-663

Cited by 13 publications

(13 citation statements)

References 42 publications

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“…A multidisciplinary team that includes the specialists and anesthesiologists should be involved in managing the patient, assessing the procedure risk, optimizing the perioperative conditions, and planning the appropriate treatment regimens to minimize postoperative complications and length of hospital stay [ 7 ]. In our hospital, surgeons and anesthesiologist have reached a consensus, and our indication of conducting non-intubated VATS is consistent with the world trends [ 8 , 9 ].…”

Section: Discussionmentioning

confidence: 61%

Opioid-sparing anesthesia with dexmedetomidine provides stable hemodynamic and short hospital stay in non-intubated video-assisted thoracoscopic surgery: a propensity score matching cohort study

Liou

Teng

et al. 2023

BMC Anesthesiol

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Objectives Dexmedetomidine is an alpha-2 agonist with anti-anxiety, sedative, and analgesic effects and causes a lesser degree of respiratory depression. We hypothesized that the use of dexmedetomidine in non-intubated video-assisted thoracic surgery (VATS) may reduce opioid-related complications such as postoperative nausea and vomiting (PONV), dyspnea, constipation, dizziness, skin itching, and cause minimal respiratory depression, and stable hemodynamic status. Methods Patients who underwent non-intubated VATS lung wedge resection with propofol combined with dexmedetomidine (group D) or alfentanil (group O) between December 2016 and May 2022 were enrolled in this retrospective propensity score matching cohort study. Intraoperative vital signs, arterial blood gas data, perioperative results and treatment outcomes were analyzed. Of 100 patients included in the study (group D, 50 and group O, 50 patients), group D had a significantly lower degree of decrement in the heart rate and the blood pressure than group O. Intraoperative one-lung arterial blood gas revealed lower pH and significant ETCO2. The common opioid-related side effects, including PONV, dyspnea, constipation, dizziness, and skin itching, all of which occurred more frequently in group O than in group D. Patients in group O had significantly longer postoperative hospital stay and total hospital stay than group D, which might be due to opioid-related side effects postoperatively. Conclusions The application of dexmedetomidine in non-intubated VATS resulted in a significant reduction in perioperative opioid-related complications and maintenance with acceptable hemodynamic performance. These clinical outcomes found in our retrospective study may enhance patient satisfaction and shorten the hospital stay.

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Section: Discussionmentioning

confidence: 61%

Opioid-sparing anesthesia with dexmedetomidine provides stable hemodynamic and short hospital stay in non-intubated video-assisted thoracoscopic surgery: a propensity score matching cohort study

Liou

Teng

et al. 2023

BMC Anesthesiol

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“…The technique for NIVATS anesthesia has been already described in detail ( 13 ). Briefly, the laryngeal mask airway (LMA) was inserted into the pharynx and combined with regional anesthesia with intercostal and vagus block.…”

Section: Methodsmentioning

confidence: 99%

Effects of Non-intubated Video-Assisted Thoracic Surgery on Patients With Pulmonary Dysfunction

et al. 2022

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Background: Non-intubated video-assisted thoracic surgery (NIVATS) can be safely performed in lung volume reduction surgery for patients with severe pulmonary dysfunction. However, there is still no cohort observation on the effects of NIVATS on patients with pulmonary dysfunction undergoing different types of thoracic procedures. This retrospective study aimed to observe the effects of NIVATS for this kind of patients.Methods: Three hundred and twenty-eight patients with moderate to severe obstructive pulmonary dysfunction, who underwent video-assisted thoracic surgery (VATS), were retrospectively collected from June 1st, 2017 to September 30th, 2019. Patients in NIVATS were case-matched with those in intubated video-assisted thoracic surgery (IVATS) by a propensity score-matched analysis. The primary outcome was the comparison of perioperative values, the secondary outcome was the risk factors for postoperative clinical complications (PCP) which were identified by binary logistic regression analysis.Results: After being matched, there were no differences in demographics and preoperative values of pulmonary function between NIVATS and IVATS groups. The duration of surgery and anesthesia had no difference (P = 0.091 and P = 0.467). As for the postoperative recovery, except for the mean intensive care unit (ICU) stay was longer in the IVATS group than in the NIVATS group (P = 0.015), the chest tube removal time and the postoperative hospital stay had no difference (P = 0.394 and P = 0.453), and the incidence of PCP also had no difference (P = 0.121). The binary logistic regression analysis revealed that the history of pulmonary disease, anesthesia method, and surgical location were risk factors of PCP.Conclusion: For patients with pulmonary dysfunction when undergoing different types of thoracic procedures, the NIVATS can be performed as effectively and safely as the IVATS, and can reduce the ICU stay.

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“…The non-intubated approach is a promising thoracic procedure for GGNs and early-stage lung cancer, providing a safe, beneficial, less invasive alternative to intubated VATS, and enabling significantly shorter hospital stays 147 . During the spontaneous ventilation video-assisted thoracic surgery (SV-VATS) procedure, intraoperative intubation, post-operative chest tube placement, and urinary catheterization are avoided, thereby simplifying the surgical steps, decreasing patients' post-operative discomfort, and enabling faster recovery 148 . However, patients may be ineligible for surgery because of comorbidities, poor physical conditions, or poor pulmonary function 149 .…”

Section: Exploration Of Treatment Strategies For Suspected Malignancymentioning

confidence: 99%

Advances in lung cancer screening and early detection

Wang

Jiang

et al. 2022

Cancer Biol Med

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Lung cancer is associated with a heavy cancer-related burden in terms of patients’ physical and mental health worldwide. Two randomized controlled trials, the US-National Lung Screening Trial (NLST) and Nederlands-Leuvens Longkanker Screenings Onderzoek (NELSON), indicated that low-dose CT (LDCT) screening results in a statistically significant decrease in mortality in patients with lung cancer, LDCT has become the standard approach for lung cancer screening. However, many issues in lung cancer screening remain unresolved, such as the screening criteria, high false-positive rate, and radiation exposure. This review first summarizes recent studies on lung cancer screening from the US, Europe, and Asia, and discusses risk-based selection for screening and the related issues. Second, an overview of novel techniques for the differential diagnosis of pulmonary nodules, including artificial intelligence and molecular biomarker-based screening, is presented. Third, current explorations of strategies for suspected malignancy are summarized. Overall, this review aims to help clinicians understand recent progress in lung cancer screening and alleviate the burden of lung cancer.

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Tubeless video-assisted thoracic surgery for pulmonary ground-glass nodules: expert consensus and protocol (Guangzhou)

Cited by 13 publications

References 42 publications

Opioid-sparing anesthesia with dexmedetomidine provides stable hemodynamic and short hospital stay in non-intubated video-assisted thoracoscopic surgery: a propensity score matching cohort study

Opioid-sparing anesthesia with dexmedetomidine provides stable hemodynamic and short hospital stay in non-intubated video-assisted thoracoscopic surgery: a propensity score matching cohort study

Effects of Non-intubated Video-Assisted Thoracic Surgery on Patients With Pulmonary Dysfunction

Advances in lung cancer screening and early detection

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