[Comparison of non-intubated, spontaneously breathing and intubated, mechanically ventilated videothoracoscopic...

Introduction: The minimally invasive thoracic surgery (video-assisted thoracic surgery, VATS) became the focus in connection with lung cancer treatment in the last few decades. One of the most important techniques is the non-intubated, spontaneously breathing thoracic procedure. Objective: In this study, we compare the results of non-intubated, non-relaxated (Group I) and intubated, relaxated (Group II) uniportal lobectomies. Method: We retrospectively reviewed and compared 118 Group I and 211 Group II patients’ data, and then, in each group, 70-70 patients were selected with propensity score match and statistically analyzed. Results: Mean operation time was 91.6 and 91.1 minutes (p = 0.857), the mean chest tube removal was 3.43 and 4.62 days (p<0.001), the prolonged airleak rate was 12.8% and 20.8% (p = 0.07), the redrainage rate was 7.7% and 6.16% (p = 0,624), the reoperation rate was 2.5% and 5.2% (p = 0.393), and the morbidity was 18.8%, and 27.9%, (p = 0,065) in Group I and Group II, respectively. 30-day mortality occurred only in Group I. After propensity score match analysis, the mean operation time was 92.08 and 95.25 minutes (p = 0.442), the mean chest tube removal was 3.01 and 4.57 days (p<0.01), prolonged airleak rate was 11.4% and 20% (p = 0.164), redrainage rate was 5.7% and 7.24% (p = 0.730), reoperation rate was 2.8% and 5.6% (p = 0.681), and the morbidity was 15.7% and 27.1%) (p = 0.099) in Group I and Group II, respectively. 30-day mortality did not occur in any of the 2 groups. Conclusions: In general, the non-intubated and non-relaxated VATS uniportal lobectomy showed better results compared to intubated, relaxated patients. The time of chest tube removal was shorter and the complication rate was also lower. Orv Hetil. 2024; 165(10): 393–399.