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M. Hung



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    P3.07 - Poster Session 3 - Surgery (ID 193)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Surgery
    • Presentations: 1
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      P3.07-020 - Nonintubated Thoracoscopic Lobectomy for Lung Cancer: Experience of Two Medical Centers from Taiwan and China (ID 1783)

      09:30 - 09:30  |  Author(s): M. Hung

      • Abstract

      Background
      General anesthesia with single-lung ventilation is considered mandatory for thoracoscopic lobectomy for non-small cell lung cancer (NSCLC). Nonintubated thoracoscopic lobectomy has rarely been reported previously. The objective of this study was to evaluate the feasibility and safety of thoracoscopic lobectomy without endotracheal intubation.

      Methods
      From August 2009 through March 2013, 196 patients with clinical stage I or II NSCLC were treated by non-intubated thoracoscopic lobectomy using epidural anesthesia, intrathoracic vagal blockade, and sedation at National Taiwan University Hospital, Taiwan, and The First Affiliated Hospital of Guangzhou Medical College, China.

      Results
      The mean age of the patients were 59 years and 128 (65.3%) were female. Collapse of the operative lung and inhibition of coughing were satisfactory in the non-intubated patients, induced by spontaneous breathing and vagal blockade. Sixteen patients (8.2%) required conversion to intubated-single lung ventilation because of significant mediastinal movement, persistent hypoxemia, dense pleural adhesions, and bleeding. Two patients were converted to standard thoracotomy because of bleeding. The mean postoperative chest tube drainage and postoperative hospital stay were 3.6 days and 6.8 days, respectively. Postoperative complications were noted in 23 (11.7%) patients, including prolonged air leaks, arrhythmia, pneumonia, and bleeding. No operation mortalities were noted.

      Conclusion
      Non-intubated thoracoscopic lobectomy is technically feasible and safe. It can be a valid alternative of single-lung ventilated thoracoscopic lobectomy in managing selected patients with early-stage NSCLC.