Awake video-assisted thoracic surgery in acute XXXX .

@entity1 @entity1143 @entity825 @entity9285 @entity548 @entity358
BACKGROUND: Many of thoracic minimally invasive interventions have been proven to be possible without general anesthesia. This article presents results of video-assisted thoracic surgery (VATS) application under local anesthesia in @entity1 with lung abscesses and discusses its indications in detail. METHODS: The study involved prospective analysis of treatment outcomes for all acute @entity358 (AIPD) @entity1 undergoing VATS under local anesthesia and sedation since January 1, 2010, till December 31, 2013. @entity1 with @entity358 at periphery of large size (>5 cm) underwent non-intubated video abscessoscopy (NIVAS). @entity1 with pyopneumothorax (lung abscess penetration into @entity1143 ) underwent non-intubated video thoracoscopy (NIVTS). Indications for NIVAS and NIVTS were as follows: cavity debridement and washing, necrotic sequestra removal, adhesion split, biopsy. All interventions were done under local anesthesia and sedation without @entity825 intubation and epidural anesthesia. RESULTS: Sixty-five enrolled @entity1 had 42 NIVAS and 32 NIVTS interventions, nine @entity1 underwent two surgeries. None of the @entity1 required @entity825 intubation or epidural anesthesia. In none of our cases with conversion to thoracotomy was required. Post-surgical complications developed after 11 interventions (13%): @entity9285 (five cases), chest wall phlegmon (three cases), @entity548 (two cases), and pneumothorax (one case). One @entity1 died due to the main disease progression. In 50 @entity1 NIVAS and NIVTS were done within 5 to 8 days after abscess/ @entity1143 draining, while in other 15 @entity1 -immediately prior to draining; both @entity548 episodes and all cases of chest wall phlegmon took place in the latter group. CONCLUSIONS: NIVAS and NIVTS under local anesthesia and sedation are well tolerated by @entity1 , safe and should be used more often in AIPD cases. Timing of NIVAS and NIVTS procedures was found to be of paramount importance for ensuring complete therapeutic effectiveness.
