Outcomes of Non-intubated Versus Intubated Thoracoscopic Surgery for Primary Spontaneous Pneumothorax
Surgical Laparoscopy, Endoscopy and Percutaneous Techniques, cilt.33, sa.5, ss.487-492, 2023 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 33 Sayı: 5
- Basım Tarihi: 2023
- Doi Numarası: 10.1097/sle.0000000000001213
- Dergi Adı: Surgical Laparoscopy, Endoscopy and Percutaneous Techniques
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CINAHL, MEDLINE
- Sayfa Sayıları: ss.487-492
- Anahtar Kelimeler: awake, non-intubated, primary spontaneous pneumothorax, thoracoscopy, VATS
- Trakya Üniversitesi Adresli: Evet
Özet
Background: This study aimed to compare the outcomes of non-intubated video-assisted thoracic surgery (N-VATS) and intubated video-assisted thoracic surgery (I-VATS) for primary spontaneous pneumothorax (PSP). Materials and Methods: We retrospectively analyzed 120 consecutive patients who underwent VATS for PSP. The patients were divided into N-VATS and I-VATS groups. Demographics, clinical characteristics, postoperative results, pain scores, follow-up results, and management were evaluated and compared between the groups. Local anesthesia and deep sedation (ketamine 2 mg/kg IV and propofol 2 mg/kg IV slow infusion) were administered under spontaneous ventilation in the N-VATS group. Results: The groups did not differ significantly in terms of age, sex, American Society of Anesthesiology score, pneumothorax side, or smoking history (P>0.05). The mean operation time, anesthesia time, oral intake opening time, and mobilization time were significantly shorter in the N-VATS group (26.04±4.61 vs. 48.26±7.82 min, 42.14±6.40 vs. 98.16±12.4 min, 2.1±0.4 vs. 8.4±1.2 h, and 4.2±0.9 vs. 2.6±1.4 between N-VATS and I-VATS, respectively; P<0.05). The surgical outcomes did not differ in terms of minor complications (12%-13%) and recurrence rates (5.1%-6.4%) during a mean follow-up period of 88.4±10.2 mo. No cases of conversion to open surgery or mortality were observed. General anesthesia and intubation were not required for any patient in the N-VATS group. Conclusions: Our results revealed no differences in minor complications or recurrence rates between groups. However, the N-VATS group had significantly shorter operation, anesthesia, oral intake opening, and mobilization times. The most important advantage of N-VATS for PSP is its fast recovery while avoiding the risks of general anesthesia and intubation. Further prospective studies with larger sample sizes are warranted.