BMC anesthesiology · 2025
Comparison of non-intubated and intubated video-assisted thoracoscopic surgery for perioperative complications-a systematic review and meta-analysis.
СтатьяСистематический обзорМетаанализСравнительное исследованиеНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Zhang Diaofeng, Wu Jie, Yang Yihan, Pu Ruifang, Liu Zixiao, Li Yun, Deng Wei, Wang Jiale, Hou Bo, Ge Zengcai, Gao Jiao, Li Jiangang, Cheng Liming
Аннотация
BACKGROUND: Non-intubated video-assisted thoracic surgery (NIVATS) avoids lung injury and intubation-related complications from mechanical ventilation, but the intraoperative safety and postoperative recovery quality of NIVATS remain controversial. Consequently, we systematically assessed the viability and safety of non-intubated video-assisted thoracic surgery (NIVATS) in comparison to intubated video-assisted thoracic surgery (IVATS). These findings provide evidence for optimizing anesthetic and surgical decision-making.
METHODS: PubMed, Web of Science, Embase, Cochrane Library, OVID, and Google Scholar were queried from their establishment until October 2024. We included eligible studies that compared non-intubated anesthesia with intubated anesthesia for video-assisted thoracoscopic surgery for thoracic conditions. Following the evaluation of bias risk in these randomized controlled trials (RCTs), a meta-analysis was conducted using Review Manager (Manager 5.4).
RESULTS: Nineteen randomized controlled trials were incorporated into the study. NIVATS demonstrated a reduced length of hospital stay, feeding time, and chest-tube dwell time compared to intubated methods. IVATS groups, hypoxemia exhibited a reduced incidence, but perioperative cough and perioperative arrhythmias revealed no statistically significant differences between IVATS and NIVATS groups. The NIVATS groups exhibited a significantly reduced risk compared to the IVATS groups for postoperative pulmonary complications (PPCs), postoperative nausea and vomiting (PONV), and sore throat.
CONCLUSIONS: NIVATS avoid complications associated with intubation and are able to accelerate patient recovery to a certain extent. Although NIVATS carries intraoperative safety risks, careful patient selection can mitigate these risks.
METHODS: PubMed, Web of Science, Embase, Cochrane Library, OVID, and Google Scholar were queried from their establishment until October 2024. We included eligible studies that compared non-intubated anesthesia with intubated anesthesia for video-assisted thoracoscopic surgery for thoracic conditions. Following the evaluation of bias risk in these randomized controlled trials (RCTs), a meta-analysis was conducted using Review Manager (Manager 5.4).
RESULTS: Nineteen randomized controlled trials were incorporated into the study. NIVATS demonstrated a reduced length of hospital stay, feeding time, and chest-tube dwell time compared to intubated methods. IVATS groups, hypoxemia exhibited a reduced incidence, but perioperative cough and perioperative arrhythmias revealed no statistically significant differences between IVATS and NIVATS groups. The NIVATS groups exhibited a significantly reduced risk compared to the IVATS groups for postoperative pulmonary complications (PPCs), postoperative nausea and vomiting (PONV), and sore throat.
CONCLUSIONS: NIVATS avoid complications associated with intubation and are able to accelerate patient recovery to a certain extent. Although NIVATS carries intraoperative safety risks, careful patient selection can mitigate these risks.