For a study, researchers evaluated the techniques of spontaneous-ventilation video-assisted thoracoscopic surgery (SV-VATS) for tracheal/carinal resections and compared the results to those of the traditional thoracoscopic intubated method. From May 2015 to November 2016, SV-VATS resection was used to treat 18 malignant or benign illnesses infiltrating the distal trachea and carina who met the SV criteria. Researchers compared a control group of 14 consecutive patients with the same illnesses who had VATS resection utilizing intubated general anesthesia from October 2014 to April 2015 to assess the feasibility of this unique approach. Researchers used a median follow-up of 10.2 months to gather data 75. (range: 1-27).
Four carinal resections and 14 tracheal resections were performed in the SV-VATS group. Two patients in the control group had a carinal resection, and 12 had a tracheal resection. The SV-VATS group had a shorter median operating time (162.5 minutes vs. 260 minutes), as well as a shorter median time for end-to-end tracheal anastomosis (22.5 minutes vs. 45 minutes) and carinal reconstruction (22.5 minutes vs. 45 minutes) (40 minutes vs. 86 minutes). During the procedure, the lowest oxygen saturation was (94.2% ± 4.9%) in the SV-VATS group and (93.9% ± 4.5%) in the control group. The SV-VATS group had a higher peak carbon dioxide level at the end of expiration (47.7 ± 4.2 mm Hg versus 39.1 ± 5.7 mm Hg). In the SV-VATS group, Researchers did not require tracheal intubation. Six patients in the SV-VATS group and nine in the control group experienced postoperative problems. SV-VATS patients demonstrated a trend toward shorter postoperative hospital stays (11.5 ± 4.3 days versus 13.2 ± 6.3 days). One recurrence (SV-VATS group) and two fatalities (one in each group) were detected during follow-up. SV-VATS is a viable treatment for tracheal and carinal excision and repair in highly chosen patients. It has the potential to be a viable alternative to intubated VATS for airway surgery.
Reference:www.jtcvs.org/article/S0022-5223(18)30405-7/fulltext
