医学
肺癌
电视胸腔镜手术
纵隔淋巴结
胸腔镜肺叶切除术
通风(建筑)
心胸外科
楔形切除术
麻醉
外科
机械通风
癌症
全肺切除术
转移
内科学
切除术
工程类
机械工程
作者
Chuqiao Wang,Donghong Wu,Peilin Pang,Han Kong,Jieyi Zhao,Xiaoying Chen,Jingyi Ye,Zhe Pan,Wenhua Liang,Jun Li,Jianxing He
标识
DOI:10.1053/j.jvca.2021.07.042
摘要
The aim of the present study was to compare the short-term outcomes between spontaneous ventilation video-assisted thoracic surgery (SV-VATS) and mechanical ventilation video-assisted thoracic surgery (MV-VATS) in the elderly. All patients included in the present study underwent lobectomy, segmentectomy, or wedge resection and lymph node dissection.A retrospective cohor.The first affiliated hospital of Guangzhou Medical University, Guangzhou, China.The present study included 799 elderly patients diagnosed with non-small-cell lung cancer undergoing SV-VATS or MV-VATS. After propensity score matching, 80 patients in the SV-VATS group and 80 patients in the MV-VATS group were analyzed.Patients in the SV-VATS group received spontaneous-ventilation anesthesia, which was administered as follows: intravenous anesthesia + laryngeal mask airway + thoracic paravertebral block + visceral pleural surface anesthesia + thoracic vagus nerve block. Patients in the MV-VATS group received general endotracheal anesthesia. SV-VATS or MV-VATS was performed according to the preference of the patients.There were no significant differences in anesthesia time (226.3 ± 79.8 v 238.5 ± 66.2 min; p = 0.44), surgery time (166.2 ± 102.6 v 170.1 ± 83.4 min; p = 0.66), and number of dissected lymph nodes (5.3 ± 7.5 v 4.4 ± 7.4; p = 0.23) between the two groups. There were significant differences in intraoperative bleeding (61.5 ± 165.1 v 82.2 ± 116.9 mL; p < 0.001). After surgery, the two groups were statistically comparable in terms of hospitalization (17.6 ± 7.6 v 17.2 ± 6.9 days; p = 0.95) and incidence of complications (7.5% v 13.8%; p = 0.20), while there were significant differences in chest tube duration (6.1 ± 3.3 v 4.5 ± 1.2 days; p < 0.001).SV-VATS is feasible and as safe as MV-VATS, and it could be considered as an alternative treatment for the elderly.
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