Department of Visceral, Transplant, Thoracic and Vascular Surgery, University Hospital of Leipzig, Liebigstrasse 20, 04103, Leipzig, Germany.
Department of General, Visceral, Thoracic and Vascular Surgery, Faculty of Health Sciences Brandenburg, Brandenburg Medical School, University Hospital Neuruppin, Fehrbelliner Strasse 38, 16816, Neuruppin, Germany.
BMC Anesthesiol. 2021 Feb 11;21(1):44. doi: 10.1186/s12871-021-01270-4.
Non-intubated video-assisted thoracic surgery (NiVATS) has been introduced to surgical medicine in order to reduce the invasiveness of anesthetic procedures and avoid adverse effects of intubation and one-lung ventilation (OLV). The aim of this study is to determine the time effectiveness of a NiVATS program compared to conventional OLV.
This retrospective analysis included all patients in Leipzig University Hospital that needed minor VATS surgery between November 2016 and October 2019 constituting a NiVATS (n = 67) and an OLV (n = 36) group. Perioperative data was matched via propensity score analysis, identifying two comparable groups with 23 patients. Matched pairs were compared via t-Test.
Patients in NiVATS and OLV group show no significant differences other than the type of surgical procedure performed. Wedge resection was performed significantly more often under NiVATS conditions than with OLV (p = 0,043). Recovery time was significantly reduced by 7 min (p = 0,000) in the NiVATS group. There was no significant difference in the time for induction of anesthesia, duration of surgical procedure or overall procedural time.
Recovery time was significantly shorter in NiVATS, but this effect disappeared when extrapolated to total procedural time. Even during the implementation phase of NiVATS programs, no extension of procedural times occurs.
为了降低麻醉程序的侵入性并避免插管和单肺通气（OLV）的不良反应，非插管视频辅助胸腔手术（NiVATS）已被引入外科医学。本研究旨在确定 NiVATS 计划与常规 OLV 的时间效率。
本回顾性分析包括 2016 年 11 月至 2019 年 10 月莱比锡大学医院需要进行小切口胸腔镜手术的所有患者，构成 NiVATS（n=67）和 OLV（n=36）组。通过倾向评分分析对围手术期数据进行匹配，确定了两组各 23 名具有可比性的患者。通过 t 检验比较匹配的对。
NiVATS 和 OLV 组的患者除了手术类型外没有明显差异。楔形切除术在 NiVATS 条件下进行的比例明显高于 OLV（p=0.043）。NiVATS 组的恢复时间显著缩短了 7 分钟（p=0.000）。麻醉诱导时间、手术持续时间或总手术时间无显著差异。
NiVATS 的恢复时间明显更短，但当外推到总手术时间时，这种效果就消失了。即使在 NiVATS 计划的实施阶段，也不会延长手术时间。
