eISSN: 1897-4252
ISSN: 1731-5530
Kardiochirurgia i Torakochirurgia Polska/Polish Journal of Thoracic and Cardiovascular Surgery
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1/2021
vol. 18
 
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abstract:
Original paper

First experiences in non-intubated, video-assisted thoracoscopic surgery: a single-centre study

Tayfun Kermenli
1
,
Cebrail Azar
2
,
Zafer Gundogdu
3

  1. Department of Thoracic Surgery, Istanbul Aydın University, Istanbul, Turkey
  2. Department of Chest Diseases, Medicalpark Elazığ Hospital, Istinye University, Istanbul, Turkey
  3. Department of Aesthesiology and Reanimation, Medicalpark Elazığ Hospital, Istinye University, Istanbul, Turkey
Kardiochir Torakochir Pol 2021; 18 (1): 15-22
Online publish date: 2021/05/15
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Introduction
Video-assisted thoracoscopic surgery (VATS) with non-intubated technique is safely performed under spontaneous breathing and sedation. With this surgery, many complex thoracic surgical interventions can be successfully applied.

Aim
We shared the results of our patients who underwent mediastinal biopsy, pleural biopsy, lung wedge resection, pneumothorax surgery, and pleural delocculation with non-intubated VATS.

Material and methods
Patients who underwent surgery with non-intubated VATS between March 2015 and May 2020 in our clinic were included in the study. The patients were evaluated in terms of many factors such as age, gender, applied surgical intervention, diagnosis, side of surgery, duration of surgery, and time of hospital stay, and the results were recorded retrospectively.

Results
Twenty of the patients were male and 12 were female. Regarding comorbid diseases in our patient group, 13 had extra-thoracic malignancy, 7 had hypertension, 6 had heart disease, 5 had chronic obstructive pulmonary disease and asthma, and 4 had diabetes mellitus. Pleural drainage and biopsy were performed in 10 patients and wedge resection in 8 patients. Bullectomy and apical pleural abrasion were performed in 6 patients, mediastinal mass biopsy was performed in 4 patients, and delocculation was performed in 4 patients due to empyema.

Conclusions
The non-intubated VATS approach can be safely applied in procedures such as lung resections, pleural or mediastinal interventions, and pneumothorax surgery. With this technique, the absence of intubation and mechanical ventilation facilitates the return to normal respiratory physiology, and we think that the recovery time of the patient, the duration of hospital stay, and treatment costs are reduced.

keywords:

non-intubated, video-assisted thoracoscopic surgery, local anaesthesia, sedation

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