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Nenad Ilic



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    P1.16 - Surgery (ID 702)

    • Event: WCLC 2017
    • Type: Poster Session with Presenters Present
    • Track: Surgery
    • Presentations: 1
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      P1.16-004 - Intubated Versus Non-intubated  Anesthesia for Lung Cancer  VATS  in Octogenerians (ID 8001)

      09:30 - 16:00  |  Presenting Author(s): Nenad Ilic

      • Abstract
      • Slides

      Background:
      In recent years, non-intubated video-assisted surgery (VATS) is gaining popularity worldwide, especially in elderly lung cancer patients (ELC). The main goal of this surgical practice is to achieve an overall improvement of patients management and outcome thanks to the avoidance of side-effects related to general anesthesia and single-lung ventilation. We compared non-intubated anesthetic technique with intubated general anesthetic technique for VATS. .

      Method:
      Forty octogenerians (patinets aged 80 years or more) scheduled for VATS lung cancer surgery, were allocated randomly into two groups with 20 patients each. First group received standard general anesthesia with double lumen tube. Second group went under non-intubated anesthetic technique. Heart rate, mean arterial pressure, end-tidal CO2 and the visual analog pain score (VAS) measurements were recorded during the surgery and 24 hours after the surgery. Both group received ultrasound guided paravertebral block before surgery with single injection of 20 ml 0.25% levobupivacaine. VATS lobectomy followed by sample mediastinal lymphadenectomy was performed in all patients. Figure 1



      Result:
      Time for anesthetic procedure was shorter in the nonintubated group. VATS lobecotomy was performed in usual manner in all patients without any intraoperative complications. VAS score in the first 24 hours was comparable. We found significantlly shorter recovery time, reduced oxygen requirement, shorter chest tube drainage and hospital stay in the non-intubated group. There where no significant differences in intraoperative blood loss, operation time or postoperative complications between the non-intubated group and the intubated group of patients.

      Conclusion:
      Tthis pilot study has shown that non-intubated VATS is a safe and feasible surgery for elderly lung cancer patients with certain advantages for the patients undergoing VATS.. Our results indicated that we can achieve day surgery for selected patients. Further clinical studies should be carried out in order to improve surgical outcome in elderly lung cancer patients.

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