Application of spontaneous breathing anesthesia combined with tubeless uniportal thoracoscopy in pulmonary bullae resection: A randomized controlled trial_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

ZHANG Man ¹ , JIN Zhiyong ¹ , MA Ying ¹ , DU Yiri ² , ZHONG Haiyan ² , KANG Shirong ¹ , LI Chunlin ¹ ,  LIANG Junguo ¹

1. Department of Thoracic Surgery, Affiliated Hospital of Inner Mongolia Medical University, Hohhot, 010050, P.R.China;
2. Department of Anesthesiology, Affiliated Hospital of Inner Mongolia Medical University, Hohhot, 010050, P.R.China;

Corresponding author：

LIANG Junguo, Email: Lchest@126.com

Keywords：

Spontaneous breathing anesthesia; uniportal thoracoscopy; pulmonary bullae; randomized controlled trial

DOI：

10.7507/1007-4848.201705015

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To explore the safety and feasibility of spontaneous breathing anesthesia combined with tubeless uniportal thoracoscopy in pulmonary bullae surgery. Methods Totally 112 patients with pulmonary bullae in the Affiliated Hospital of Inner Mongolia Medical University from March 2015 to May 2017 were enrolled. According to the random number chosen by computer, the patients were randomly divided into two groups: a tubeless group (spontaneous breathing anesthesia combined with tubeless uniportalthoracoscopy) and a control group (uniportal thoracoscopy by general anesthesia with tracheal intubation) . There were 49 males and 7 females with an average age of 25.5±6.5 years in the tubeless group, and 50 males and 6 females with an average age of 23.5±4.5 years in the control group. The difference of the lowest intraoperative arterial oxygen saturation (SaO₂), SaO₂ at postoperative one hour, operation time, postoperative awakening time, hospital stay, hospitalization cost and postoperative pain score were analyzed. Results There was no significant difference between the two groups in the operation time, the lowest SaO₂, SaO₂ at one hour after the operation and the partial pressure of carbon dioxide (PaCO₂). The awakening time and duration of postoperative hospital stay in the tubeless group was shorter than those in the control group (P=0.000). The cost of hospitalization in the tubeless group was less than that in the control group (P=0.000). The discomfort caused by urinary tract and visual analogue score (VAS) in the tubeless group were better than those in the control group. Conclusion It is safe and feasible to use spontaneous breathing anesthesia combined with tubeless uniportal thoracoscopy in pulmonary bullae resection.

Citation： ZHANG Man, JIN Zhiyong, MA Ying, DU Yiri, ZHONG Haiyan, KANG Shirong, LI Chunlin, LIANG Junguo. Application of spontaneous breathing anesthesia combined with tubeless uniportal thoracoscopy in pulmonary bullae resection: A randomized controlled trial. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2018, 25(3): 218-221. doi: 10.7507/1007-4848.201705015 Copy

1.	Kammerer T, Speck E, von Dossow V. Anesthesia in thoracic surgery. Anaesthesist, 2016, 65(5): 397-412.
2.	Miñambres E, Burón J, Ballesteros MA, et al. Tracheal rupture after endotracheal intubation: a literature systematic review. Eur J Cardiothorac Surg, 2009, 35(6): 1056-1062.
3.	Murphy GS, Szokol JW, Avram MJ, et al. Postoperative residual neuromuscular blockade is associated with impaired clinical recovery. Anesth Analg, 2013, 117(1): 133-141.
4.	Gonzalez-Rivas D, Fernandez R, de la Torre M, et al. Single-port thoracoscopic lobectomy in a nonintubated patient: the least invasive procedure for major lung resection? Interact Cardiovasc Thorac Surg, 2014, 19(4): 552-555.
5.	Pompeo E, Mineo D, Rogliani P, et al. Feasibility and results of awake thoracoscopic resection of solitary pulmonary nodules. Ann Thorac Surg, 2004, 78(5): 1761-1768.
6.	Hung MH, Hsu HH, Cheng YJ, et al. Nonintubated thoracoscopic surgery: state of the art and future directions. J Thorac Dis, 2014, 6(1): 2-9.
7.	王路昌, 赵德明, 吴春根. 肺大泡的 CT 表现. 中国中西医结合影像学杂志, 2014, 12(6): 663-664.
8.	李惠民, 陈晗春, 周丽敏, 等. 自发性气胸的 CT 评价. 临床放射学杂志, 2003, 22(5): 377-379.
9.	Dumans-Nizard V, Guezennec J, Parquin F, et al. Feasibility and results of a fast-track protocol in thoracic surgery. Minerva Anestesiol, 2016, 82(1): 15-21.
10.	Elia S, Guggino G, Mineo D, et al. Awake one stage bilateral thoracoscopic sympathectomy for palmar hyperhidrosis: a safe outpatient procedure. Eur J Cardiothorac Surg, 2005, 28(2): 312-317.
11.	Chen KC, Cheng YJ, Hung MH, et al. Nonintubated thoracoscopic lung resection: a 3-year experience with 285 cases in a single institution. J Thorac Dis, 2012, 4(4): 347-351.
12.	Li S, Cui F, Liu J, et al. Nonintubated uniportal video-assisted thoracoscopic surgery for primary spontaneous pneumothorax. Chin J Cancer Res, 2015, 27(2): 197-202.
13.	Li S, Liu J, He J, et al. Video-assisted transthoracic surgery resection of a tracheal mass and reconstruction of trachea under non-intubated anesthesia with spontaneous breathing. J Thorac Dis, 2016, 8(3): 575-585.
14.	Gonzalez-Rivas D, Aymerich H, Bonome C, et al. From open operations to nonintubated uniportal video-assisted thoracoscopic lobectomy: Minimizing the trauma to the patient. Ann Thorac Surg, 2015, 100(6): 2003-2005.
15.	Hung WT, Hsu HH, Hung MH, et al. Nonintubated uniportal thoracoscopic surgery for resection of lung lesions. J Thorac Dis, 2016, 8(Suppl 3): S242-S250.
16.	Watanabe A, Watanabe T, Ohsawa H, et al. Avoiding chest tube placement after video-assisted thoracoscopic wedge resection of the lung. Eur J Cardiothorac Surg, 2004, 25(5): 872-876.

1. Kammerer T, Speck E, von Dossow V. Anesthesia in thoracic surgery. Anaesthesist, 2016, 65(5): 397-412.
2. Miñambres E, Burón J, Ballesteros MA, et al. Tracheal rupture after endotracheal intubation: a literature systematic review. Eur J Cardiothorac Surg, 2009, 35(6): 1056-1062.
3. Murphy GS, Szokol JW, Avram MJ, et al. Postoperative residual neuromuscular blockade is associated with impaired clinical recovery. Anesth Analg, 2013, 117(1): 133-141.
4. Gonzalez-Rivas D, Fernandez R, de la Torre M, et al. Single-port thoracoscopic lobectomy in a nonintubated patient: the least invasive procedure for major lung resection? Interact Cardiovasc Thorac Surg, 2014, 19(4): 552-555.
5. Pompeo E, Mineo D, Rogliani P, et al. Feasibility and results of awake thoracoscopic resection of solitary pulmonary nodules. Ann Thorac Surg, 2004, 78(5): 1761-1768.
6. Hung MH, Hsu HH, Cheng YJ, et al. Nonintubated thoracoscopic surgery: state of the art and future directions. J Thorac Dis, 2014, 6(1): 2-9.
7. 王路昌, 赵德明, 吴春根. 肺大泡的 CT 表现. 中国中西医结合影像学杂志, 2014, 12(6): 663-664.
8. 李惠民, 陈晗春, 周丽敏, 等. 自发性气胸的 CT 评价. 临床放射学杂志, 2003, 22(5): 377-379.
9. Dumans-Nizard V, Guezennec J, Parquin F, et al. Feasibility and results of a fast-track protocol in thoracic surgery. Minerva Anestesiol, 2016, 82(1): 15-21.
10. Elia S, Guggino G, Mineo D, et al. Awake one stage bilateral thoracoscopic sympathectomy for palmar hyperhidrosis: a safe outpatient procedure. Eur J Cardiothorac Surg, 2005, 28(2): 312-317.
11. Chen KC, Cheng YJ, Hung MH, et al. Nonintubated thoracoscopic lung resection: a 3-year experience with 285 cases in a single institution. J Thorac Dis, 2012, 4(4): 347-351.
12. Li S, Cui F, Liu J, et al. Nonintubated uniportal video-assisted thoracoscopic surgery for primary spontaneous pneumothorax. Chin J Cancer Res, 2015, 27(2): 197-202.
13. Li S, Liu J, He J, et al. Video-assisted transthoracic surgery resection of a tracheal mass and reconstruction of trachea under non-intubated anesthesia with spontaneous breathing. J Thorac Dis, 2016, 8(3): 575-585.
14. Gonzalez-Rivas D, Aymerich H, Bonome C, et al. From open operations to nonintubated uniportal video-assisted thoracoscopic lobectomy: Minimizing the trauma to the patient. Ann Thorac Surg, 2015, 100(6): 2003-2005.
15. Hung WT, Hsu HH, Hung MH, et al. Nonintubated uniportal thoracoscopic surgery for resection of lung lesions. J Thorac Dis, 2016, 8(Suppl 3): S242-S250.
16. Watanabe A, Watanabe T, Ohsawa H, et al. Avoiding chest tube placement after video-assisted thoracoscopic wedge resection of the lung. Eur J Cardiothorac Surg, 2004, 25(5): 872-876.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Application of spontaneous breathing anesthesia combined with tubeless uniportal thoracoscopy in pulmonary bullae resection: A randomized controlled trial

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content