Comparison Of Nonintubated Versus Intubated Video-assisted Thoracoscopic Lobectomy For Lung Cancer
ZEEAD M. ALGHAMDI1, Lyfuxu Lynhiavu2, YoungKyu Moon3, MiHyoung Moon3, Seha Ahn3, Yunho Kim3, Sookwhan Sung3.
1University of Dammam, Dammam, Saudi Arabia, 2University Sciences of Health, Vientiane, Lao People's Democratic Republic, 3Seoul St. Mary's Hospital, Catholic University of Korea, Seoul, Korea, Republic of.
This study was conducted to evaluate the perioperative outcomes of the non-intubated and intubated video-assisted thoracoscopic lobectomy in lung cancer in regards to feasibility and safety.
A retrospective analysis of 62 consecutive video-assisted thoracoscopic lobectomies (31 lobectomies as non-intubated, 31 lobectomies as Intubated) performed in Seoul St. Mary’s Hospital, of the Catholic University of Korea between January to December, 2016.
Both groups share comparable clinical characteristics including the age, sex, BMI, FEV1, DLCO, smoking history, lung lobes procedure, histological type and pathological staging. There was no difference in the mean of postoperative hospitalization period (6.9 days versus 7.6 days, P-value 0.578) and the total chest tube duration (5.6 days versus 5.4 days, P-value 0.943) between non-intubated and intubated lobectomy respectively. Both groups had a comparable surgical outcome for the anesthesia duration, operative time, blood loss and postoperative complications. The operative time required for lobe-specific surgery was shorter in the non-intubated group except for the LLL (mean 121.7 minutes for non-intubated group versus 118.3 minutes for intubated group). The only statistically significant surgical outcome was for the number of dissected lymph nodes between both groups (the mean number of nodes for the non-intubated group was 12.6 versus 18 nodes for the intubated group, p-value 0.003). One patient in the non-intubated group required conversion to single lung intubation and mini-thoracotomy because of bleeding with no conversion in intubated group. No mortality encountered in either group.
The perioperative and surgical outcomes for the non-intubated video-assisted thoracoscopic lobectomy are comparable to the intubated technique. Non-intubated video-assisted thoracoscopic lobectomy is safe and is technically feasible. However, further prospective randomized studies are needed for a better comparison between non-intubated and intubated VATS lobectomy.
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