Abstract:

Objective

To explore the feasibility of non-intubated uniportal video-assisted thoracic surgery(NI UVATS) sleeve lobectomy and summarize the surgical techniques and clinical outcomes.

Methods

From Mar. 2019 to Jul. 2023, a total of 18 non-intubated uniportal VATS sleeve lobectomy were performed by the single surgical team at the Thoracic Surgery Department of the Shanghai Pulmonary Hospital.

Results

All 18 patients successfully underwent radical resection and bronchial anastomosis. No patient was converted to thoracotomy during the entire operation.The 18 cases comprised lung squamous cell carcinoma (n=13), lung adenocarcinoma (n=2), adenoid cystic carcinoma (n=1), andcarcinoid tumor(n=2). The average operation time was 118.33±19.17 minutes. The average number of lymph node stations removed was 5.71±1.69, including station seven in all cases, and the median number of lymph nodes removed was 13.24±5.88.On the day of surgery, the drainage volume was 324.71±155.17 ml. The mean postoperative hospital stay was 4.22±1.48 days.Eight of the 15 patients diagnosed with malignancy received postoperative chemotherapy. One year after the operation, two patients experienced tumor metastasis. These two patients received postoperative chemotherapy combined with immunotherapy and achieved good tumor control.1.5 years after the operation,a local recurrence in a patient with a squamous cell carcinoma. The postoperative follow-up time was 25.7±10.7 months. The mortality was zero.

Conclusions

Non-intubated uniportal VATS sleeve resections on selected patients are feasible procedures in hands of experienced uniportal VATS surgeons,teamed up with experienced anesthetists.

Key words: Uniportal video-assisted thoracic surgery (UVATS), Sleeve lobectomy, Non-Intubated