Awake thoracoscopic non-anatomic pulmonary resections under thoracic paravertebral block: Results of a tertiary referral centre
Journal of Minimal Access Surgery, cilt.21, sa.2, ss.189-194, 2025 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 21 Sayı: 2
- Basım Tarihi: 2025
- Doi Numarası: 10.4103/jmas.jmas_124_24
- Dergi Adı: Journal of Minimal Access Surgery
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE, Directory of Open Access Journals
- Sayfa Sayıları: ss.189-194
- Anahtar Kelimeler: Awake video-assisted thoracoscopic surgery, bullectomy, metastasectomy, non-intubated, outcomes, video-assisted thoracoscopic surgery
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Introduction: Awake video-assisted thoracoscopic surgery (VATS) helps to avoid the adverse effects of general anaesthesia (GA) with single-lung ventilation. Its usage in anatomic and non-anatomic pulmonary resections has spread worldwide, and it is mostly performed under thoracic epidural analgesia (TEA). We herein report our surgical experience with awake VATS non-anatomical resections under the thoracic paravertebral block (TPB). Patients and Methods: This retrospective, single-centred study reviewed patients undergoing awake VATS non-anatomical pulmonary resection under TPB, who voluntarily accepted awake VATS despite being suitable for GA and were found unsuitable for GA based on pre-operative assessment results. Demographic, pre-, per- and post-operative data were collected, analysed and compared with the literature data. Results: Twenty-four patients (16 patients with normal pre-operative assessment results and 8 patients having high risk for GA) were selected. Fourteen bullectomies for recurrent spontaneous pneumothorax and 10 wedge resections (nine for metastasectomy and one for lung biopsy) were performed. Global in-operating room time was 77 ± 31 min. The morbidity rate was 20.8% (n = 5), including prolonged air leak in three and pneumonia in two patients. The mean duration of the chest tube was 1.9 ± 1.5 days and mean duration of hospital stay was 3.5 ± 2.1 days. There was no in-hospital mortality. Our results were mostly similar to the literature data. Conclusion: Non-anatomical lung resections by VATS can be performed easily and safely under TPB in awake patients. Although the perioperative and post-operative outcomes are not superior to other anaesthesia approaches, preferring TPB may help to avoid the serious potential complications of TEA.