Study On Safety And Feasibility Of Lung Cancer Radical Operation Under Spontaneous Ventilation Anesthesia

BACKGROUND:Double-lumen endotracheal intubation general anesthesia is currently accepted as an anesthetic method for thoracoscopic surgery,but its complications have not found a good solution.In order to reduce the complications of general anesthesia with endotracheal intubation,non-intubated anesthesia with spontaneous ventilation began to be applied to video-assisted thoracoscopic surgery(VATS).This study explored the feasibility and safety of video-assisted thoracoscopic surgery for lung cancer under spontaneous ventilation anesthesia.Methods: A total of 948 patients with lung cancer who met the requirements from November 2011 to April 2018 were analyzed retrospectively,including 513 males and 435 females.All surgical methods were standard lung cancer resection(lobectomy + systemic lymphadenectomy).According to different anesthesia methods,they were divided into experimental group and control group.Among them,352 cases of spontaneous ventilation anesthesia thoracoscopic surgery group(experimental group),double lumen trachea intubation was performed on 596 patients in the thoracoscopic surgery group(control group).The operative time,intraoperative blood loss,intraoperative lymph node dissection,postoperative drainage time,postoperative hospital stay and postoperative complications were compared.Using the propensity score method,anesthesia was used as a dependent variable,and patient's age,BMI index,gender,clinical stage,and tumor site were used as independent variables to establish a logistic regression model.The data before and after matching were analyzed.RESULTS: Prior to matching,the mean operating time,and days of chest tube drainage were not significantly different between the spontaneous ventilation group and the tracheal intubation group.After matching,the distribution of all covariates reached equilibrium.There was no difference in mean intraoperative blood loss,mean operationtime,and total number of intraoperative lymph node dissections(p>0.05).However,postoperative chest tube indwelling time(2.36±1.21)days and(3.45±2.68)days in spontaneous ventilation group and tracheal intubation group,and postoperative hospital stay days were(4.16±2.79)days and(8.60±3.03)days,respectively.There was a significant difference after matching(p<0.05).CONCLUSIONS: VATS radical lung cancer surgery under spontaneous ventilation anesthesia is safe and feasible,and has a shorter postoperative time for removal of the chest tube and shorter hospital stay,helping patients recover quickly.