Abstract
ObjectiveThe aim of this study was to compare the safety feasibility and safety feasibility of non-intubated (NIVATS) and intubated video-assisted thoracoscopic surgeries (IVATS) during major pulmonary resections.MethodsA meta-analysis of eight studies was conducted to compare the real effects of two lobectomy or segmentectomy approaches during major pulmonary resections.ResultsResults showed that the patients using NIVATS had a greatly shorter hospital stay and chest-tube placement time (weighted mean difference (WMD): − 1.04 days; 95% CI − 1.50 to − 0.58; P < 0.01) WMD − 0.71 days; 95% confidence interval (CI), − 1.08 to − 0.34; P < 0.01, respectively) while compared to those with IVATS. There were no significant differences in postoperative complication rate, surgical duration, and the number of dissected lymph nodes. However, through the analysis of highly selected patients with lung cancer in early stage, the rate of postoperative complication in the NIVATS group was lower than that in the IVATS group [odds ratio (OR) 0.44; 95% CI 0.21–0.92; P = 0.03, I2 = 0%].ConclusionsAlthough the comparable postoperative complication rate was observed for major thoracic surgery in two surgical procedures, the NIVATS method could significantly shorten the hospitalized stay and chest-tube placement time compared with IVATS. Therefore, for highly selected patients, NIVATS is regarded as a safe and technically feasible procedure for major thoracic surgery. The assessment of the safety and feasibility for patients undergoing NIVATS needs further multi-center prospective clinical trials.
Highlights
Since video-assisted thoracoscopic surgery (VATS) with the double-lumen endotracheal tube and endobronchial blocker for one-lung ventilation was firstly used for the major pulmonary resections in 1992, it has been commonly adopted by thoracic surgeons due to its minimalXue et al World Journal of Surgical Oncology (2021) 19:87 lead to a mortality rate as high as 22% [6]
Results showed that non-intubated video-assisted thoracoscopic surgeries (NIVATS) significantly shortened the hospitalized stay compared to VATS (WMD − 1.04 days; 95% CI − 1.50 to − 0.58; P < 0.01) (Fig. 5)
The duration of chest-tube placement was greatly shortened with NIVATS than those with intubated video-assisted thoracoscopic surgeries (IVATS) (WMD − 0.71 days; 95% CI − 1.08 to − 0.34; P < 0.01) (Fig. 7)
Summary
Since video-assisted thoracoscopic surgery (VATS) with the double-lumen endotracheal tube and endobronchial blocker for one-lung ventilation was firstly used for the major pulmonary resections in 1992, it has been commonly adopted by thoracic surgeons due to its minimalXue et al World Journal of Surgical Oncology (2021) 19:87 lead to a mortality rate as high as 22% [6]. Since video-assisted thoracoscopic surgery (VATS) with the double-lumen endotracheal tube and endobronchial blocker for one-lung ventilation was firstly used for the major pulmonary resections in 1992, it has been commonly adopted by thoracic surgeons due to its minimal. The utilization of VATS with spontaneous ventilation in mediastinal biopsies [9], metastatic tumors [10], bullectomy [11], empyema thoracic [12], pulmonary biopsies [13], pleural effusion [14], spontaneous pneumothorax [15], and nonanatomical resections has determined that this technique is a safe, efficient, and feasible technique for thoracic surgery [10]. Non-intubated anesthesia has been gradually developed to minimize the damages of VATS. This makes the surgeons easier to use the non-intubated video-assisted thoracoscopic surgeries (NIVATS) in the anatomical lung resection [8]. There were many advantages for NIVATS with one-lung spontaneous ventilation than IVATS with mechanical ventilation, there are few papers to systematically compare the differences in NIVATS and IVATS in terms of safety and feasibility to patients during their major pulmonary resections
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
