Author of

• 20125

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  OA 04 - Surgery from Minimal to Radical (ID 661)

  • Event: WCLC 2017
  • Type: Oral
  • Track: Surgery
  • Presentations: 1
  • Moderators:J. Lee, A. Chang
  • Coordinates: 10/16/2017, 15:45 - 17:30, Room 311 + 312

  • 23040

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    OA 04.07 - Initial Results of Tubeless Single-Port Thoracoscopic Surgery for Pulmonary Tumor (ID 8924)

    16:50 - 17:00  |  Author(s): P. Hsu
    • Abstract
    • Presentation
    • Slides

    Background:
    Tubeless technique, defined as non-intubated anesthesia and omitting chest tube after lung resection surgery, is a new concept to further minimize surgical trauma of thoracoscopic surgery. However, the feasibility and safety have been less investigated. Here we set up a protocol to prevent postoperative pneumothorax after tubeless single-port thoracoscopic surgery with the aid of digital chest drainage system (DCS).
    
    Method:
    From Nov. 2016 to Jun. 2017, 34 consecutive non-intubated single-port thoracoscopic surgery were performed in patients with pulmonary nodules. After excluding patients with nodule≧2 cm, intrapleural adhesion, and FEV1< 1.5 L/sec., 21 patients were selected to enter the tubeless protocol. At the end of the procedure, a single 16-Fr. catheter was placed into the pleural cavity and connected to a DCS which pressure was set at −15 cmH2O. Then the single incision was closed continuously. If the air flow reached zero after completion of wound closure, the catheter will be removed immediately; otherwise the catheter will be kept for drainage. The clinical characteristics and perioperative outcomes of patients were presented. Figure 1
    
    
    
    Result:
    Among tubeless protocol cases, 3 patients were detected to have minor air leak by DCS and were converted to have intrapleural drainage remained after closure of surgical wound. Among the remaining 18 patients, in whom the DCS showed no air leak, the intrapleural drainage catheter was not placed. Immediate postoperative chest roentgenogram showed full expansion in all protocol patients without pneumothorax. Only 5 (23.8%) patients developed minor subclinical pneumothorax on the first postoperative day. All patients were discharged uneventful without the need of intervention.
    
    Conclusion:
    Our tubeless protocol utilizes DCS to select patients for omitting intrapleural drainage after non-intubated single-port thoracoscopic surgery. With objective parameters by DCS, we believe that this is an effective way to reduce the rate of pneumothorax after tubeless single-port thoracoscopic surgery in selected patients after lung resection.
    
    

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