Hung Ming-Hui, Yang Shun-Mao, Chen Jin-Shing
Department of Anesthesiology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan.
J Vis Surg. 2017 Feb 13;3:10. doi: 10.21037/jovs.2017.01.10. eCollection 2017.
Nonintubated video-assisted thoracic surgery (VATS) is now well established and is performed in different institutions as a safe and versatile procedure in selected patients. To share the surgical and anesthetic techniques for nonintubated VATS, we present a 56-year-old female patient who underwent nonintubated VATS left upper lobectomy for primary non-small cell lung cancer. Our patient was sedated in a spontaneous breathing status using a target-controlled infusion of propofol. Additionally, regional anesthesia using intercostal block and left-sided intrathoracic vagal block enabled us to do left upper lobectomy and mediastinal lymph node dissection without difficulty. After an uneventful postoperative recovery, our patient was discharged to her home on postoperative day 3. The final pathology showed a well-differentiated adenocarcinoma without any involvement of mediastinal lymph node, measuring 27 mm in its maximal dimension. Nonintubated VATS lobectomy can be a safe and effective procedure providing satisfactory clinical outcomes in the patient.
非插管电视辅助胸腔镜手术（VATS）目前已得到广泛应用，在不同机构中，它作为一种安全且多功能的手术，用于特定患者。为了分享非插管VATS的手术和麻醉技术，我们介绍一位56岁的女性患者，她因原发性非小细胞肺癌接受了非插管VATS左上叶切除术。我们的患者在自主呼吸状态下通过靶控输注丙泊酚进行镇静。此外，使用肋间阻滞和左侧胸内迷走神经阻滞的区域麻醉使我们能够顺利地进行左上叶切除术和纵隔淋巴结清扫。术后恢复顺利，患者于术后第3天出院。最终病理显示为高分化腺癌，纵隔淋巴结无转移，最大直径为27mm。非插管VATS肺叶切除术可以是一种安全有效的手术，为患者提供满意的临床结果。
