Video-assisted thoracoscopic surgery using single-lumen endotracheal tube anesthesia

Chest
Robert James CerfolioAlfred A Bartolucci

Abstract

Most general thoracic surgeons use double-lumen endotracheal tube (DLET) anesthesia for all video-assisted thoracoscopic surgery (VATS). We evaluated a single-lumen endotracheal tube (SLET) for VATS for drainage of pleural effusions and pleural biopsies. A consecutive series of patients with recurrent pleural effusions underwent VATS using an SLET and only one incision. Operations were accomplished via one 2-cm incision using a 5-mm rigid thoracoscope and mediastinoscopic biopsy forceps for directed pleural biopsies. A working area was accomplished with low tidal volumes. There were 376 patients (191 women). The indications for VATS were a nondiagnosed or benign pleural effusion in 294 patients, and a malignant effusion in 82 patients. Two hundred eight patients underwent biopsy of the parietal pleura, and mean operative time was 17 min. Adequate visibility was obtained in all. When compared to preoperative cytology, VATS was more sensitive (45% compared to 99%, p < 0.001), had a higher negative predictive value (56% compared to 99%, p < 0.001), and was more accurate (67% compared to 99%, p < 0.001). Forty-seven percent of patients with a history of cancer had false-negative preoperative cytology results. Complications occurred...Continue Reading

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Citations

Jul 27, 2010·Respirology : Official Journal of the Asian Pacific Society of Respirology·Yeung-Leung ChengChing Tzao
Apr 22, 2010·Journal of Minimal Access Surgery·Karamollah ToolabiAbbas Rabani
Jun 15, 2007·AORN Journal·Fadi M Khraim
Aug 9, 2006·Lung Cancer : Journal of the International Association for the Study of Lung Cancer·Siyamek Neragi-Miandoab
Dec 3, 2014·Journal of Cardiothoracic and Vascular Anesthesia·Dong Kyu LeeHeezoo Kim
Nov 8, 2017·Expert Review of Respiratory Medicine·Deirdre B FitzgeraldY C Gary Lee
Jul 19, 2008·Seminars in Cardiothoracic and Vascular Anesthesia·Francis Theodore Lytle, Daniel R Brown
Nov 7, 2019·Minimally Invasive Therapy & Allied Technologies : MITAT : Official Journal of the Society for Minimally Invasive Therapy·Mengnan ZhaoQun Wang
Feb 14, 2020·Journal of Cardiothoracic Surgery·Lu Huu PhamUoc Huu Nguyen

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