Key result
A-VATS and NI-VATS prove safe and effective for minor thoracic procedures without general anesthesia.
Why the study?
Awake video-assisted thoracoscopic surgery (A-VATS) offers a safer alternative to traditional VATS and non-intubated VATS by avoiding muscle relaxants and sedoanalgesics, especially benefiting elderly patients and those with severe comorbidities.
Does awake, non-intubated VATS improve safety and outcomes compared to traditional VATS or open surgery in thoracic surgery patients?
Does awake, non-intubated VATS improve safety and outcomes compared to traditional VATS or open surgery in thoracic surgery patients?
Awake and non-intubated VATS are safe and effective alternatives to traditional VATS with general anesthesia for select thoracic procedures, particularly in high-risk patients.
May support awake diagnostic VATS in select pleural cases; leaves open need for RCTs versus standard approaches.
Awake video-assisted thoracoscopic surgery (A-VATS) enables the surgeon to penetrate the tissue via a small incision and with less contact between the lung and atmospheric pressure; postoperative respiratory functions are also less affected than in open surgery. A-VATS is a safer technique than traditional VATS and non-intubated video-assisted thoracoscopic surgery (NI-VATS) because it does not require muscle relaxants and sedoanalgesics. In particular, diagnostic VATS for pleural effusions can be easily performed over a single port using only local anaesthetic. Anaesthesia-related risks increase even more for elderly patients and those with severe comorbidities. Although there are long and risky operations in thoracic surgery, general anaesthesia is not required for some thoracic surgery procedures. However, A-VATS is limited to minor procedures. Due to regional anaesthesia and sedation, NI-VATS is a safe and effective method for many indications. The results show that this method can be applied with low mortality and morbidity.
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Fazlı Yanık (2023) conducted a review in Thoracic surgery indications. Awake video-assisted thoracoscopic surgery (A-VATS) and non-intubated VATS vs. Traditional VATS and open surgery was evaluated. Awake video-assisted thoracoscopic surgery (A-VATS) and non-intubated VATS are safe and effective for minor thoracic procedures, offering low mortality and morbidity without general anaesthesia.
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