Background: Traditionally, video-assisted thoracic surgery (VATS) is performed under general anesthesia with selective ventilation and endotracheal intubation. Although some sparse data exists on VATS under local anesthesia, most series reserve this technique for pleural-based surgery. Performing VATS under local anesthesia may extend the benefits of this procedure to those unable to tolerate general anesthesia and improve outcomes.
Method: We have extended this technique to include more complex procedures, with results that surpass traditional open thoracotomies. We analyzed 293 patients who underwent awake video-assisted thoracic surgery (AVATS) from June 2010 to January 2014.
Results: Procedures such as pleural biopsies, wedge resections, decortications, and even lobectomies were able to be safely performed using AVATS technique with comparable or better results than VATS under general anesthesia.
Conclusion: AVATS is a feasible technique with equal or improved outcomes without compromise in safety. Further study may help delineate the role of this technique in the care of the thoracic surgical patient.
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http://dx.doi.org/10.1186/s13019-014-0149-x | DOI Listing |
J Cardiothorac Surg
January 2025
Department of Anesthesiology, The First People's Hospital of Chenzhou, Chenzhou, Hunan Province, 423000, China.
Background: Chronic post-surgical pain (CPSP) is a common complication following video-assisted thoracoscopic surgery (VATS) that significantly impacts the quality of life of patients. Although multiple risk factors have been identified, no systematically validated prediction model exists to guide clinical decision-making.
Objectives: This study aimed to develop and validate a risk prediction model for CPSP in patients undergoing VATS for lung cancer.
World J Surg Oncol
January 2025
Department of General Thoracic Surgery, Friendship Hospital, No. 2 Yinghua East Road, Chaoyang District, 100029, Beijing, China.
Background: The aim of this study was to compare the surgical efficacy of one-stage and two-stage video-assisted thoracoscopic surgery (VATS) for bilateral multiple pulmonary nodules (BMPNs).
Methods: A retrospective analysis was made of 156 patients, 84 who underwent one-stage and 72 who underwent two-stage VATS for BMPNs at our department between January 2019 and December 2022. Perioperative and long-term outcomes were compared between the two groups using propensity score-matched (PSM) analysis.
Thorac Cancer
January 2025
Department of Thoracic Surgery, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
Background: Ipsilateral shoulder pain (ISP) is a common complication following video-assisted thoracoscopic surgery (VATS), significantly affecting postoperative recovery and quality of life. This study aimed to evaluate the relationship between intraoperative upper limb positioning, and the occurrence of ISP, with the goal of optimizing positioning to reduce postoperative complications.
Methods: This prospective cohort study included 252 patients undergoing VATS for lung resection.
Quant Imaging Med Surg
January 2025
Department of Interventional Therapy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Background: Accurate localization of small pulmonary nodules (SPNs) during video-assisted thoracoscopic surgery (VATS) is challenging due to the small size and deep location. Both the 4-hook wire technique and methylene blue are significant methods for preoperative localization of SPNs. This study aimed to compare the safety of both methods by monitoring and recording any surgery-related complications.
View Article and Find Full Text PDFMultimed Man Cardiothorac Surg
January 2025
Division of Thoracic Surgery University of Padua via Giustiniani 2 35128 Padua Italy.
In patients with suspected interstitial lung disease, diagnostic confirmation can be achieved through an awake video-assisted surgical lung biopsy. This procedure enables the collection of a substantial amount of parenchymal tissue for diagnostic purposes while minimizing perioperative complications associated with mechanical ventilation with the patient under general anaesthesia, given the impaired lung function due to the underlying condition.
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