Nonintubated Needlescopic Video-Assisted Thoracic Surgery for Management of Peripheral Lung Nodules

摘要: Background. Video-assisted thoracic operations are usually performed with 5-mm or 10-mm instruments under general anesthesia single-lung ventilation. Management of peripheral lung nodules by a needlescopic video-assisted thoracoscopic operation, without endotracheal intubation, has rarely been attempted. We evaluated the feasibility and safety this minimally invasive technique in managing nodules. Methods. From August 2009 through March 2011, 46 patients were treated using 3-mm for wedge resection epidural sedation, intubation. Results. A definitive diagnosis was obtained all 46. Extension incisions required 8 because primary cancer requiring lobectomy 3, pleural adhesions difficulty identifying resecting nodule 2. Two conversion to intubated ventilation dense between lungs diaphragm. Operations lasted mean 69.2 46.8 minutes. Postoperative side effects occurred 4 patients, including sore throat, headache, vomiting medication. Operative complications developed 1 patient who had air leaks more than 3 days postoperatively. The postoperative chest tube drainage hospital stay 1.1 2.7 days, respectively. neuralgia noted 12 (26%). Most (74%) very satisfied resulting scars. Conclusions. Nonintubated technically feasible safe may be less alternative management selected pulmonary