초록접수 현황
| 17F-289 | 구연 발표 |
Non-intubated Thoracoscopic Surgery: Initial Experience of Single Center
Youngkyu Moon¹, Seha Ahn¹, Joon Pyo Jeon², Won Jung Hwang², Yunho Kim¹, Sook Whan Sung¹
¹Department of Thoracic and Cardiovascular Surgery, Seoul St. Mary’s Hospital, The Catholic University College of Medicine, Seoul, Republic of Korea., ²Department of Anesthesiology, Seoul St. Mary’s Hospital, The Catholic University College of Medicine, Seoul, Republic of Korea
Purpose : Non-intubated surgery is one of the emerging issues in minimal invasive thoracic surgery. We started non-intubated VATS lung resection on 30th August 2016. We would like to report our experience with non-intubated thoracoscopic surgery for one year.
Methods : From August 2016 to August 2017, 110 consecutive patients underwent non-intubated thoracoscopic surgery by a single surgeon. After the anesthesiologist administers the sedative agent to the patient, we apply local anesthesia. Mixed 2% lidocaine and 0.5% bupivacaine in 1:1 ratio are injected into the port sites and intercostal nerves (3rd to 9th). When performing anatomical resection, local anesthesia is also applied to the right paratracheal area or left subaortic area where the vagus nerve passes.
Results : There were 79 (71.8 %) patients were lung cancers undergone pulmonary resections. Other 31 (18.2 %) patients were diagnosed with pulmonary metastasis, benign lung diseases or pleural diseases. The mean anesthesia time was 170 min (±53.6). The mean operative duration was 128.7 min (±52.2). The mean postoperative chest tube duration was 3.9 days (±4.9). The mean hospital stay was 5.9 days (±3.2). There were 9 conversions (8.2 %) to intubation due to intraoperative hypoxemia, severe pleural adhesion or bleeding. There were 17 complications (15.5 %) among the patients: 7 prolonged air leakage, 3 arrhythmia, 2 chylothorax, and 5 pulmonary complications. Those complications were resolved during the hospital stays. There was no postoperative mortality.
Conclusion : Nonintubated thoracoscopic surgery appears to be feasible surgical options, and it can be a valid alternative of one-lung ventilated thoracoscopic surgery.
Methods : From August 2016 to August 2017, 110 consecutive patients underwent non-intubated thoracoscopic surgery by a single surgeon. After the anesthesiologist administers the sedative agent to the patient, we apply local anesthesia. Mixed 2% lidocaine and 0.5% bupivacaine in 1:1 ratio are injected into the port sites and intercostal nerves (3rd to 9th). When performing anatomical resection, local anesthesia is also applied to the right paratracheal area or left subaortic area where the vagus nerve passes.
Results : There were 79 (71.8 %) patients were lung cancers undergone pulmonary resections. Other 31 (18.2 %) patients were diagnosed with pulmonary metastasis, benign lung diseases or pleural diseases. The mean anesthesia time was 170 min (±53.6). The mean operative duration was 128.7 min (±52.2). The mean postoperative chest tube duration was 3.9 days (±4.9). The mean hospital stay was 5.9 days (±3.2). There were 9 conversions (8.2 %) to intubation due to intraoperative hypoxemia, severe pleural adhesion or bleeding. There were 17 complications (15.5 %) among the patients: 7 prolonged air leakage, 3 arrhythmia, 2 chylothorax, and 5 pulmonary complications. Those complications were resolved during the hospital stays. There was no postoperative mortality.
Conclusion : Nonintubated thoracoscopic surgery appears to be feasible surgical options, and it can be a valid alternative of one-lung ventilated thoracoscopic surgery.
책임저자: Sook Whan Sung
Department of Thoracic and Cardiovascular Surgery, Seoul St. Mary’s Hospital, The Catholic University College of Medicine, Seoul, Republic of Korea
발표자: Sook Whan Sung, E-mail : swsung@catholic.ac.kr