Spontaneous versus mechanical ventilation during video-assisted thoracoscopic surgery for spontaneous pneumothorax: A randomized trial Conference Paper uri icon

  •  
  • Overview
  •  
  • Research
  •  
  • Identity
  •  
  • View All
  •  

abstract

  • OBJECTIVE: Spontaneous ventilation video-assisted thoracic surgery (SV-VATS) is reported to have superior or equal efficacy on postoperative recovery to mechanical ventilation VATS (MV-VATS). However, perioperative safety of the SV-VATS blebectomy is not entirely demonstrated. METHODS: We performed a noninferiority, randomized controlled trial (No. NCT03016858) for primary spontaneous pneumothorax patients aged 16 to 50 years undergoing a SV-VATS and the MV-VATS procedure. The trial was conducted at 10 centers in China from April 2017 to January 2019. The primary outcome was the comparison of intra- and postoperative complications between SV-VATS and MV-VATS procedures. Secondary outcomes included total analgesia dose, change of vital sign during surgery, procedural duration, recovery time, postoperative visual analog pain scores, and hospitalization length. RESULTS: In this study, 335 patients were included. There was no significant difference between the SV-VATS group and the MV-VATS group in the intra- and postoperative complication rates (17.90% vs 22.09%; relative risk, 0.81; 95% confidence interval, 0.52-1.26; P = .346). The SV-VATS group was associated with significantly decreased total dose of intraoperative opioid agents; that is, sufentanil (11.37 μg vs 20.92 μg; P < .001) and remifentanil (269.78 μg vs 404.96 μg; P < .001). The SV-VATS procedure was also associated with shorter extubation time (12.28 minutes vs 17.30 minutes; P < .001), postanesthesia care unit recovery time (25.43 minutes vs 30.67 minutes; P = .02) and food intake time (346.07 minute vs 404.02 minutes; P = .002). Moreover, the SV-VATS procedure deceased the anesthesia cost compared with the MV-VATS ($297.81 vs $399.81; P < .001). CONCLUSIONS: SV-VATS was shown to be noninferior to MV-VATS in term of complication rate and in selected patients undergoing blebectomy for primary spontaneous pneumothorax.

authors

  • Liu, Jun
  • Liang, Hengrui
  • Cui, Fei
  • Liu, Hui
  • Zhu, Chengchu
  • Liang, Wenhua
  • He, Jianxing
  • Liu, Jun
  • Liang, Hengrui
  • Cui, Fei
  • Wang, Wei
  • Jiang, Shunjun
  • Liang, Wenhua
  • He, Jianxing
  • Liu, Hui
  • Dong, Qinglong
  • Liang, Lixia
  • Yang, Hanyu
  • Li, Yingfen
  • Zhu, Chengchu
  • Jin, Jiang
  • Shen, Jianfei
  • Dai, Tianyang
  • He, Kaiming
  • Cai, Kaican
  • Feng, Siyang
  • Wang, Haofei
  • Zhang, Zhifeng
  • Huang, Haoda
  • Cheng, Chao
  • Liu, Zhenguo
  • Qiao, Kun
  • Xia, Zhaohua
  • Liu, Xiang
  • Wang, Guangsuo
  • Huang, Tonghai
  • Xu, Shun
  • Shen, Qiming
  • Tan, Wenfei
  • Ding, Jinfeng
  • Liu, Yulin
  • Ye, Jing
  • Yu, Jiang
  • Zhang, Huangkai
  • Feng, Xia
  • Ma, Mingfei
  • Duan, Zhongxin
  • Li, Yali
  • Ma, Hong
  • Ng, Calvin SH
  • González-Rivas, Diego
  • Pompeo, Eugenio
  • Daley, Erlin
  • Flores, Raja M
  • Shargall, Yaron
  • Ismail, Mahmoud
  • Ang, Keng-Leong
  • Ambrogi, Vincenzo
  • Elkhouly, Ahmed

publication date

  • February 2021