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Awake Thoracic Surgery By Uniportal Thoracoscopic Surgery: One Surgeon’S Experience
Kalliopi ATHANASSIADI, Evangelia Liverakou, Ioanna Sigala, Konstantinos Elefteriou, Elefteria Mizi, Paraskevi Katsaounou, Ioannis Kalomenidis;
"EVANGELISMOS" General Hospital, Athens, Greece
OBJECTIVE: The objective of the current study was to evaluate the feasibility and safety of nonintubated uniportal video-assisted thoracoscopic surgery (VATS) for the management of different pleural diseases, infections and pulmonary nodules. METHODS: From 2014 to 2023, 198 consecutive patients with different pleural diseases, infections and pulmonary nodules were treated by non-intubated, non-ventilated uniportal thoracoscopic surgery and sedation by using propofol, fentanyl and pethidine without the presence of an anaesthesist. An incision of 2 cm in length was made either at the 5th, 6th or 7th intercostal space depending on the location of the lesion. The pleural space was entered for placement of a soft incision protector. Different procedures were performed, such as drainage of pleural effusions, drainage of hemothoraces in trauma cases, pleural biopsies, decortication and drainage of empyemas, and resection of pulmonary nodules. RESULTS: The average time of surgery was 41.0 min. No complications were recorded. The mean postoperative chest tube drainage was 2-15 days, depending on the underlying disease. No recurrences were observed at follow-up. CONCLUSION: The initial results indicated that nonintubated uniportal VATS operations are not only technically feasible and cost-effective, but may also be a safe and less invasive alternative for selected patients in the management of different diseases.
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