Essentials in spontaneous ventilation video-assisted thoracoscopic surgery: how we do it

Kód výsledku v IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00216224%3A14110%2F22%3A00133848" target="_blank" >RIV/00216224:14110/22:00133848 - isvavai.cz</a>

Výsledek na webu

<a href="https://asj.amegroups.org/article/view/55671/html" target="_blank" >https://asj.amegroups.org/article/view/55671/html</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.21037/asj-21-37" target="_blank" >10.21037/asj-21-37</a>

Jazyk výsledku

angličtina

Název v původním jazyce

Essentials in spontaneous ventilation video-assisted thoracoscopic surgery: how we do it

Popis výsledku v původním jazyce

Spontaneous ventilation non-intubated thoracic surgery (NITS) has roots in authentic tradition, and yet is radically new. It appreciates inherent physiological functions and engages up-to-date knowledge of physiology, pharmacology, and device technology. The interdisciplinary collaboration between surgery and anaesthesia is refined. The compliance of the lungs and the thoracic wall is supported by high-flow nasal oxygenation (HFNO). The depth of anaesthesia with propofol is monitored by bispectral index (BIS). BIS score is optimally maintained between 40–60. The procedures include foreign body extraction, pulmonary wedge resections, thoracic wall or mediastinal tumours extirpation, anatomical pulmonary resection, lobar or sublobar, up to pneumonectomy. The method significantly reduces preoperative preparation and postoperative care. During the preparatory stage of the operation, artificial pneumothorax (PNO) is introduced under propofol sedation and HFNO is performing the utility incision(s) in local anaesthesia. Bupivacaine and lidocaine are used. Then inner intercostal regional anaesthesia in the third to the eighth intercostal space is administered. A vagal block follows using a sheathed long needle. Thereafter, routine thoracic surgery continues without any technical difference in comparison with established video-assisted thoracoscopic surgery (VATS) with intubation and artificial breathing. NITS has one specific feature: the three types of unwitting pulmonary, mediastinal and thoracic wall movement than can emerge after PNO introduction: 1/mild, 2/moderate, 3/severe (significant). It is not possible to predict which of these will appear. In mild and moderate types (about 90% of patients) every kind of procedure is feasible. The severe type signals the need for conversion to an intubation procedure with artificial breathing. Contraindications of NITS include obesity, gastroesophageal reflux disease, large pleural adhesions, and significant pulmonary movement.

Název v anglickém jazyce

Essentials in spontaneous ventilation video-assisted thoracoscopic surgery: how we do it

Popis výsledku anglicky

Spontaneous ventilation non-intubated thoracic surgery (NITS) has roots in authentic tradition, and yet is radically new. It appreciates inherent physiological functions and engages up-to-date knowledge of physiology, pharmacology, and device technology. The interdisciplinary collaboration between surgery and anaesthesia is refined. The compliance of the lungs and the thoracic wall is supported by high-flow nasal oxygenation (HFNO). The depth of anaesthesia with propofol is monitored by bispectral index (BIS). BIS score is optimally maintained between 40–60. The procedures include foreign body extraction, pulmonary wedge resections, thoracic wall or mediastinal tumours extirpation, anatomical pulmonary resection, lobar or sublobar, up to pneumonectomy. The method significantly reduces preoperative preparation and postoperative care. During the preparatory stage of the operation, artificial pneumothorax (PNO) is introduced under propofol sedation and HFNO is performing the utility incision(s) in local anaesthesia. Bupivacaine and lidocaine are used. Then inner intercostal regional anaesthesia in the third to the eighth intercostal space is administered. A vagal block follows using a sheathed long needle. Thereafter, routine thoracic surgery continues without any technical difference in comparison with established video-assisted thoracoscopic surgery (VATS) with intubation and artificial breathing. NITS has one specific feature: the three types of unwitting pulmonary, mediastinal and thoracic wall movement than can emerge after PNO introduction: 1/mild, 2/moderate, 3/severe (significant). It is not possible to predict which of these will appear. In mild and moderate types (about 90% of patients) every kind of procedure is feasible. The severe type signals the need for conversion to an intubation procedure with artificial breathing. Contraindications of NITS include obesity, gastroesophageal reflux disease, large pleural adhesions, and significant pulmonary movement.

Druh

J_ost - Ostatní články v recenzovaných periodicích

CEP obor

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OECD FORD obor

30212 - Surgery

Projekt

—

Návaznosti

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Rok uplatnění

2022

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Název periodika

AME Surgical Journal

ISSN

2788-578X

e-ISSN

—

Svazek periodika

2

Číslo periodika v rámci svazku

June 2022

Stát vydavatele periodika

CN - Čínská lidová republika

Počet stran výsledku

7

Strana od-do

1-7

Kód UT WoS článku

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EID výsledku v databázi Scopus

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