Nonintubated versus intubated thoracoscopic bullectomy for primary spontaneous pneumothorax: A multicenter propensity-matched analysis
| Autor: | Ahmed G Elkhouly, Yekta Altemur Karamustafaoglu, Carlos Galvez, Madhuri Rao, Philip Lerut, Annelies Grimonprez, Firas Abu Akar, Michael Peer, Benedetta Bedetti, Davide Tosi, Akif Turna, Mohamed Elkahwagy, Eugenio Pompeo |
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| Rok vydání: | 2022 |
| Předmět: |
Pulmonary and Respiratory Medicine
Adult Adolescent Thoracic Surgery Video-Assisted thoracoscopy Pneumothorax VATS General Medicine primary spontaneous pneumothorax Young Adult Treatment Outcome nonintubated anesthesia Settore MED/21 Drainage Humans Surgery Cardiology and Cardiovascular Medicine spontaneous ventilation Retrospective Studies |
| Zdroj: | Asian cardiovascularthoracic annals. 30(9) |
| ISSN: | 1816-5370 |
| Popis: | BackgroundWe aimed at comparing in a multicenter propensity-matched analysis, results of nonintubated versus intubated video-assisted thoracic surgery (VATS) bullectomy/blebectomy for primary spontaneous pneumothorax (PSP).MethodsEleven Institutions participated in the study. A total of 208 patients underwent VATS bullectomy by intubated (IVATS) (N = 138) or nonintubated (NIVATS) (N = 70) anesthesia during 60 months. After propensity matching, 70 pairs of patients were compared. Anesthesia in NIVATS included intercostal (N = 61), paravertebral (N = 5) or thoracic epidural (N = 4) block and sedation with (N = 24) or without (N = 46) laryngeal mask under spontaneous ventilation. In the IVATS group, all patients underwent double-lumen-intubation and mechanical ventilation. Primary outcomes were morbidity and recurrence rates.ResultsThere was no difference in age (26.7 ± 8 vs 27.4 ± 9 years), body mass index (19.7 ± 2.6 vs 20.6 ± 2.5), and American Society of Anesthesiology score (2 vs 2). Main results show no difference both in morbidity (11.4% vs 12.8%; p = 0.79) and recurrence free rates (92.3% vs 91.4%; p = 0.49) between NIVATS and IVATS, respectively, whereas a difference favoring the NIVATS group was found in anesthesia time ( p ConclusionResults of this multicenter propensity-matched study have shown no intergroup difference in morbidity and recurrence rates whereas shorter operation room time and hospital stay favored the NIVATS group, suggesting a potential increase in the role of NIVATS in surgical management of PSP. Further prospective studies are warranted. |
| Databáze: | OpenAIRE |
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