Tubeless Uniportal Thoracoscopic Wedge Resection for Peripheral Lung Nodules

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• 作者：Shun-Mao Yang ; MD^a ; ^b ; ^&lowast ; ; Man-Ling Wang ; MD^c ; ^&lowast ; ; Ming-Hui Hung ; MD^c ; Hsao-Hsun Hsu ; MD ; PhD^b ; ^{ntuhsu@gmail.com} ; Ya-Jung Cheng ; MD ; PhD^c ; Jin-Shing Chen ; MD ; PhD^b ; ^d
• 刊名：The Annals of Thoracic Surgery
• 出版年：2017
• 出版时间：February 2017
• 年：2017
• 卷：103
• 期：2
• 页码：462-468
• 全文大小：814 K
• 卷排序：103

文摘

Endotracheal intubation and chest tube drainage are considered mandatory for thoracoscopic pulmonary resection. The management of peripheral lung nodules by tubeless uniportal thoracoscopic surgical repair has not been reported previously.MethodsFrom October 2015 through January 2016, 30 consecutive patients with peripheral lung nodules underwent uniportal thoracoscopic wedge resection without endotracheal intubation and chest tube drainage (tubeless group). The clinical outcomes were compared with the outcomes in 30 consecutive patients with peripheral lung nodules who underwent uniportal thoracoscopic wedge resection with chest tube drainage from April through October 2015 (chest tube group).ResultsThe demographic, anesthetic, and operative characteristics of the patients were comparable in both groups. No major adverse events occurred after operation. A small residual pneumothorax was noted in 12 (40.0%) patients at 6 hours and day 1 and in 2 (6.6%) patients on day 14 in the tubeless group. No patient required reintervention or readmission to the hospital. Patients in the tubeless group had lower pain scale scores on postoperative day 1 (mean, 1.0 vs 1.5, p = 0.012) and shorter postoperative hospital stays (mean, 3.1 days vs 4.4 days, p = 0.011) than did those in the chest tube group.ConclusionsTubeless uniportal thoracoscopic wedge resection is feasible and safe and may be a less invasive alternative for treating selected patients with peripheral lung nodules.