Abstract
With the growing adoption of Enhanced Recovery after Surgery protocols across all
surgical groups including thoracic surgery, coupled with improved video assisted thoracoscopic
surgery (VATS) equipment and techniques, non-intubated thoracoscopic surgery has gained
significant popularity in recent years. The avoidance of tracheal intubation with
endotracheal tube or double lumen tube and general anesthesia may reduce or eliminate
the risks associated with traditional mechanical ventilation, one-lung ventilation
and general anesthesia. Studies have shown a trend towards better preservation of
postoperative respiratory function and improved postoperative lengths of hospital
stay, morbidity and mortality, however these have not been conclusively proven. This
review article discusses the advantages of non-intubated VATS, the types of thoracic
surgery in which this technique has been described, patient selection, appropriate
anesthetic techniques, surgical concerns, potential complications relevant to the
anesthesiologist during the conduct of non-intubated VATS surgery, and suggested management
of these complications.
Keywords
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