General anesthesia with one-lung ventilation is considered mandatory for videothoracoscopic pulmonary resection but has some adverse effects, which can contribute to the overall procedure-related morbidity. This finding has led to the concept of a more physiologic and globally less-invasive approach, entailing awake thoracoscopic pulmonary resection under sole epidural anesthesia. Indications, although still investigational, include resection of undetermined solitary pulmonary nodules, pulmonary metastases, and non-small cell lung cancer in high-risk patients. Preliminary results have been highly satisfactory, showing that this modality is feasible, safe, and effective. Furthermore, some evidence seems to show that this patient-friendly approach could be more cost-effective, allow a more rapid recovery, and require reduced hospitalization. Further investigation and larger prospective studies will eventually confirm the real effectiveness and proper indications of awake videothoracoscopic pulmonary resections. © 2008 Elsevier Inc. All rights reserved.

Pompeo, E., & Mineo, T.C. (2008). Awake Operative Videothoracoscopic Pulmonary Resections. THORACIC SURGERY CLINICS, 18(3), 311-320 [10.1016/j.thorsurg.2008.04.006].

Awake Operative Videothoracoscopic Pulmonary Resections

POMPEO, EUGENIO;MINEO, TOMMASO CLAUDIO
2008

Abstract

General anesthesia with one-lung ventilation is considered mandatory for videothoracoscopic pulmonary resection but has some adverse effects, which can contribute to the overall procedure-related morbidity. This finding has led to the concept of a more physiologic and globally less-invasive approach, entailing awake thoracoscopic pulmonary resection under sole epidural anesthesia. Indications, although still investigational, include resection of undetermined solitary pulmonary nodules, pulmonary metastases, and non-small cell lung cancer in high-risk patients. Preliminary results have been highly satisfactory, showing that this modality is feasible, safe, and effective. Furthermore, some evidence seems to show that this patient-friendly approach could be more cost-effective, allow a more rapid recovery, and require reduced hospitalization. Further investigation and larger prospective studies will eventually confirm the real effectiveness and proper indications of awake videothoracoscopic pulmonary resections. © 2008 Elsevier Inc. All rights reserved.
Pubblicato
Rilevanza internazionale
Articolo
Sì, ma tipo non specificato
Settore MED/21 - Chirurgia Toracica
English
Con Impact Factor ISI
anesthetic agent; bupivacaine; midazolam; propofol; ropivacaine; sufentanil; endoscopic surgery; epidural anesthesia; epidural hematoma; general anesthesia; human; intermethod comparison; lung injury; lung nodule; lung non small cell cancer; lung resection; lung ventilation; nerve paralysis; panic; pathophysiology; peroperative care; phrenic nerve paralysis; postoperative complication; priority journal; review; spinal cord injury; thoracoscopy; treatment indication; treatment planning; wakefulness; Anesthesia, Epidural; Conscious Sedation; Humans; Lung Diseases; Pneumonectomy; Thoracic Surgery, Video-Assisted; Treatment Outcome
Pompeo, E., & Mineo, T.C. (2008). Awake Operative Videothoracoscopic Pulmonary Resections. THORACIC SURGERY CLINICS, 18(3), 311-320 [10.1016/j.thorsurg.2008.04.006].
Pompeo, E; Mineo, Tc
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/2108/28728
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