초록접수 현황
| 16F-265 | 구연 발표 |
Safety and Feasibility of Non-intubated Video-assisted Thoracoscopic Lung Biopsy for Interstitial Lung Disease
Chang Seok Jeon, Su Min Shin, Jong Ho Cho
Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
Background : Surgical lung biopsy plays an important role in providing pathologic results for interstitial lung disease(ILD). Recent study of around 12,000 surgical lung biopsies from US Nationwide Inpatient Sample revealed that in-hospital mortality after surgery was 1.7 % for elective procedures, and 16.0% for non-elective procedures. We assumed that non-intubated thoracic surgery might be helpful for prevention of postoperative mortality from surgery because it doesn’t cause positive pressure to respiratory airway. The aim of our study was to assess the feasibility and safety of non-intubated VATS lung biopsy.
Methods : We retrospectively analyzed patients with ILD undergoing VATS lung biopsy at a single institution between January 2016 and June 2016. A total of 34 consecutive patients were included for analysis and divided into two groups: Intubated Group (25 patients) and Non-intubated Group (9 patients). Early outcome data including intraoperative and postoperative variables were compared between subgroups.
Results : Baseline characteristics (age, sex, BMI, smoking status) were similar between two groupsn, but Non-intubated Group had higher ASA status than intubated Group (Non-intubated: median III /Intubated: median II; p<0.001). Comparisons between Intubated Group and Non-Intubated Group results showed no intergroup differences in operative time, intraoperative blood loss, chest tube dwelling period, overall postoperative chest drainage volume and hospital stay. However, anesthetic time was higher in Non-intubated group than Intubated group (Non-intubated: median 65 min[range, 60-86] /Intubated: median 83 min[range, 58-155];p=0.002). There were no in-hospital mortality or significant complications in both groups, and we could get final histologic diagnosis for all patients (Diagnostic yield : 100%).
Conclusion : In this study, we experienced that non-intubated VATS lung biopsy utilizing epidural anesthesia and sedation were well tolerated and safe. Further investigation is warranted to assess the long-term effects and diagnosis rate of this less invasive surgical strategy.
Methods : We retrospectively analyzed patients with ILD undergoing VATS lung biopsy at a single institution between January 2016 and June 2016. A total of 34 consecutive patients were included for analysis and divided into two groups: Intubated Group (25 patients) and Non-intubated Group (9 patients). Early outcome data including intraoperative and postoperative variables were compared between subgroups.
Results : Baseline characteristics (age, sex, BMI, smoking status) were similar between two groupsn, but Non-intubated Group had higher ASA status than intubated Group (Non-intubated: median III /Intubated: median II; p<0.001). Comparisons between Intubated Group and Non-Intubated Group results showed no intergroup differences in operative time, intraoperative blood loss, chest tube dwelling period, overall postoperative chest drainage volume and hospital stay. However, anesthetic time was higher in Non-intubated group than Intubated group (Non-intubated: median 65 min[range, 60-86] /Intubated: median 83 min[range, 58-155];p=0.002). There were no in-hospital mortality or significant complications in both groups, and we could get final histologic diagnosis for all patients (Diagnostic yield : 100%).
Conclusion : In this study, we experienced that non-intubated VATS lung biopsy utilizing epidural anesthesia and sedation were well tolerated and safe. Further investigation is warranted to assess the long-term effects and diagnosis rate of this less invasive surgical strategy.
책임저자: Jong Ho Cho
Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
발표자: Chang Seok Jeon, E-mail : csjeonmd@gmail.com