Nonintubated video-assisted thoracic surgery: myth or reality?

Area of Science:

• Thoracic Surgery
• Minimally Invasive Procedures
• Anesthesiology

Background:

• Nonintubated video-assisted thoracic surgery (NIVATS) has emerged as an alternative to conventional intubated thoracic surgery.
• It offers potential advantages such as reduced complications, faster recovery, and enhanced patient satisfaction.

Purpose of the Study:

• To review the physiological and technical aspects of NIVATS.
• To present recent clinical data and outcomes from the literature.

Main Methods:

• Literature review of studies on NIVATS.
• Analysis of different NIVATS approaches (awake vs. asleep).
• Examination of anesthetic and pain management strategies for NIVATS.

Main Results:

• NIVATS has gained traction over the past two decades.
• Techniques include awake-NIVATS and asleep-NIVATS, supported by various sedatives and regional anesthesia.
• Studies indicate NIVATS is feasible and safe with appropriate patient selection and team collaboration.
• Preliminary evidence suggests improved patient outcomes, though data is limited.

Conclusions:

• The feasibility of NIVATS is established in the literature.
• NIVATS shows potential for improving patient outcomes.
• High-quality international randomized multicenter trials are required to definitively compare NIVATS with intubated VATS and confirm its safety and perioperative benefits.