Non-intubated anesthesia in patients undergoing video-assisted thoracoscopic surgery: A systematic review and meta-analysis
Autoři:
Mei-gang Yu aff001; Ren Jing aff001; Yi-jie Mo aff003; Fei Lin aff001; Xue-ke Du aff001; Wan-yun Ge aff001; Hui-jun Dai aff001; Zhao-kun Hu aff001; Sui-sui Zhang aff001; Ling-hui Pan aff001
Působiště autorů:
Department of Anesthesiology, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, Guangxi, China
aff001; The Laboratory of Perioperative Medicine Research Center, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, Guangxi, China
aff002; Department of Anesthesiology, The People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China
aff003
Vyšlo v časopise:
PLoS ONE 14(11)
Kategorie:
Research Article
prolekare.web.journal.doi_sk:
https://doi.org/10.1371/journal.pone.0224737
Souhrn
Introduction
Non-intubated anesthesia (NIA) has been proposed for video-assisted thoracoscopic surgery (VATS), although how the benefit-to-risk of NIA compares to that of intubated general anesthesia (IGA) for certain types of patients remains unclear. Therefore, the aim of the present meta-analysis was to understand whether NIA or IGA may be more beneficial for patients undergoing VATS.
Methods
A systematic search of Cochrane Library, Pubmed and Embase databases from 1968 to April 2019 was performed using predefined criteria. Studies comparing the effects of NIA or IGA for adult VATS patients were considered. The primary outcome measure was hospital stay. Pooled data were meta-analyzed using a random-effects model to determine the standard mean difference (SMD) with 95% confidence intervals (CI).
Results and discussion
Twenty-eight studies with 2929 patients were included. The median age of participants was 56.8 years (range 21.9–76.4) and 1802 (61.5%) were male. Compared to IGA, NIA was associated with shorter hospital stay (SMD -0.57 days, 95%CI -0.78 to -0.36), lower estimated cost for hospitalization (SMD -2.83 US, 95% CI -4.33 to -1.34), shorter chest tube duration (SMD -0.32 days, 95% CI -0.47 to -0.17), and shorter postoperative fasting time (SMD, -2.76 days; 95% CI -2.98 to -2.54). NIA patients showed higher levels of total lymphocytes and natural killer cells and higher T helper/T suppressor cell ratio, but lower levels of interleukin (IL)-6, IL-8 and C-reactive protein (CRP). Moreover, NIA patients showed lower levels of fibrinogen, cortisol, procalcitonin and epinephrine.
Conclusions
NIA enhances the recovery from VATS through attenuation of stress and inflammatory responses and stimulation of cellular immune function.
Klíčová slova:
Hospitals – Immune response – Inflammation – Surgical and invasive medical procedures – Cellular stress responses – Anesthesia – General anesthesia
Zdroje
1. Reichert M, Kerber S, Alkoudmani I, Bodner J (2016) Management of a solitary pulmonary arteriovenous malformation by video-assisted thoracoscopic surgery and anatomic lingula resection: video and review. Surg Endosc 30: 1667–1669. doi: 10.1007/s00464-015-4337-0 26156615
2. Zahid I, Nagendran M, Routledge T, Scarci M (2011) Comparison of video-assisted thoracoscopic surgery and open surgery in the management of primary empyema. Curr Opin Pulm Med 17: 255–259. doi: 10.1097/MCP.0b013e3283473ffe 21519265
3. Chou YP, Lin HL, Wu TC (2015) Video-assisted thoracoscopic surgery for retained hemothorax in blunt chest trauma. Curr Opin Pulm Med 21: 393–398. doi: 10.1097/MCP.0000000000000173 25978625
4. Bendixen M, Jorgensen OD, Kronborg C, Andersen C, Licht PB (2016) Postoperative pain and quality of life after lobectomy via video-assisted thoracoscopic surgery or anterolateral thoracotomy for early stage lung cancer: a randomised controlled trial. Lancet Oncol 17: 836–844. doi: 10.1016/S1470-2045(16)00173-X 27160473
5. Ettinger DS, Aisner DL, Wood DE, Akerley W, Bauman J, et al. (2018) NCCN Guidelines Insights: Non-Small Cell Lung Cancer, Version 5.2018. J Natl Compr Canc Netw 16: 807–821. doi: 10.6004/jnccn.2018.0062 30006423
6. Kiss G, Claret A, Desbordes J, Porte H (2014) Thoracic epidural anaesthesia for awake thoracic surgery in severely dyspnoeic patients excluded from general anaesthesia. Interact Cardiovasc Thorac Surg 19: 816–823. doi: 10.1093/icvts/ivu230 25035439
7. Bahk JH (2002) Guidelines for determining the appropriateness of double-lumen endobronchial tube size. Anesth Analg 95: 501.
8. Xue FS, Sun C, Liu GP (2017) Assessing influence of thermal softened double-lumen endobronchial tube on postoperative airway injury and morbidity: a call for methodology clarification. Br J Anaesth 118: 139–140. doi: 10.1093/bja/aew416 28039251
9. Innes ME (2018) First-attempt success of emergency intubation with bougie was higher than with endotracheal tube plus stylet. Ann Intern Med 169: JC40. doi: 10.7326/ACPJC-2018-169-8-040 30326084
10. Nezu K, Kushibe K, Tojo T, Takahama M, Kitamura S (1997) Thoracoscopic wedge resection of blebs under local anesthesia with sedation for treatment of a spontaneous pneumothorax. Chest 111: 230–235. doi: 10.1378/chest.111.1.230 8996022
11. Pompeo E, Rogliani P, Tacconi F, Dauri M, Saltini C, et al. (2012) Randomized comparison of awake nonresectional versus nonawake resectional lung volume reduction surgery. J Thorac Cardiovasc Surg 143: 47–54, 54.e41. doi: 10.1016/j.jtcvs.2011.09.050 22056369
12. Chen JS, Cheng YJ, Hung MH, Tseng YD, Chen KC, et al. (2011) Nonintubated thoracoscopic lobectomy for lung cancer. Ann Surg 254: 1038–1043. doi: 10.1097/SLA.0b013e31822ed19b 21869676
13. Shi Y, Yu H, Huang L, Wang S, Chi D, et al. (2018) Postoperative pulmonary complications and hospital stay after lung resection surgery: A meta-analysis comparing nonintubated and intubated anesthesia. Medicine (Baltimore) 97: e10596.
14. Zheng H, Hu XF, Jiang GN, Ding JA, Zhu YM (2017) Nonintubated-Awake Anesthesia for Uniportal Video-Assisted Thoracic Surgery Procedures. Thorac Surg Clin 27: 399–406. doi: 10.1016/j.thorsurg.2017.06.008 28962712
15. Ambrogi V, Sellitri F, Perroni G, Schillaci O, Mineo TC (2017) Uniportal video-assisted thoracic surgery colorectal lung metastasectomy in non-intubated anesthesia. J Thorac Dis 9: 254–261. doi: 10.21037/jtd.2017.02.40 28275472
16. Guo Z, Yin W, Pan H, Zhang X, Xu X, et al. (2016) Video-assisted thoracoscopic surgery segmentectomy by nonintubated or intubated anesthesia: A comparative analysis of short-term outcome. Journal of Thoracic Disease 8: 359–368. doi: 10.21037/jtd.2016.02.50 27076930
17. Liu J, Cui F, Pompeo E, Gonzalez-Rivas D, Chen H, et al. (2016) The impact of non-intubated versus intubated anaesthesia on early outcomes of video-assisted thoracoscopic anatomical resection in non-small-cell lung cancer: a propensity score matching analysis. Eur J Cardiothorac Surg 50: 920–925. doi: 10.1093/ejcts/ezw160 27165771
18. Mineo TC, Sellitri F, Vanni G, Gallina FT, Ambrogi V (2017) Immunological and Inflammatory Impact of Non-Intubated Lung Metastasectomy. Int J Mol Sci 18.
19. Moher D, Liberati A, Tetzlaff J, Altman DG, Group P (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ 339: b2535. doi: 10.1136/bmj.b2535 19622551
20. Di Nisio M, Peinemann F, Porreca E, Rutjes AW (2015) Primary prophylaxis for venous thromboembolism in patients undergoing cardiac or thoracic surgery. Cochrane Database Syst Rev: CD009658. doi: 10.1002/14651858.CD009658.pub2 26091835
21. Zheng SL, Roddick AJ (2019) Association of Aspirin Use for Primary Prevention With Cardiovascular Events and Bleeding Events: A Systematic Review and Meta-analysis. JAMA 321: 277–287. doi: 10.1001/jama.2018.20578 30667501
22. Carbine NE, Lostumbo L, Wallace J, Ko H (2018) Risk-reducing mastectomy for the prevention of primary breast cancer. Cochrane Database Syst Rev 4: CD002748. doi: 10.1002/14651858.CD002748.pub4 29620792
23. Rucker G, Schwarzer G, Carpenter JR, Schumacher M (2008) Undue reliance on I(2) in assessing heterogeneity may mislead. BMC Med Res Methodol 8: 79. doi: 10.1186/1471-2288-8-79 19036172
24. Luo D, Wan X, Liu J, Tong T (2018) Optimally estimating the sample mean from the sample size, median, mid-range, and/or mid-quartile range. Stat Methods Med Res 27: 1785–1805. doi: 10.1177/0962280216669183 27683581
25. Wan X, Wang W, Liu J, Tong T (2014) Estimating the sample mean and standard deviation from the sample size, median, range and/or interquartile range. BMC Med Res Methodol 14: 135. doi: 10.1186/1471-2288-14-135 25524443
26. Liu J, Cui F, Li S, Chen H, Shao W, et al. (2015) Nonintubated video-assisted thoracoscopic surgery under epidural anesthesia compared with conventional anesthetic option: a randomized control study. Surg Innov 22: 123–130. doi: 10.1177/1553350614531662 24821259
27. Pompeo E, Dauri M (2013) Is there any benefit in using awake anesthesia with thoracic epidural in thoracoscopic talc pleurodesis? J Thorac Cardiovasc Surg 146: 495–497.e491. doi: 10.1016/j.jtcvs.2013.03.038 23601750
28. Pompeo E, Mineo D, Rogliani P, Sabato AF, Mineo TC (2004) Feasibility and results of awake thoracoscopic resection of solitary pulmonary nodules. Ann Thorac Surg 78: 1761–1768. doi: 10.1016/j.athoracsur.2004.05.083 15511470
29. Pompeo E, Tacconi F, Mineo D, Mineo TC (2007) The role of awake video-assisted thoracoscopic surgery in spontaneous pneumothorax. J Thorac Cardiovasc Surg 133: 786–790. doi: 10.1016/j.jtcvs.2006.11.001 17320585
30. Vanni G, Tacconi F, Sellitri F, Ambrogi V, Mineo TC, et al. (2010) Impact of awake videothoracoscopic surgery on postoperative lymphocyte responses. Ann Thorac Surg 90: 973–978. doi: 10.1016/j.athoracsur.2010.04.070 20732526
31. Cui F, Liu J, Li S, Yin W, Xin X, et al. (2016) Tubeless video-assisted thoracoscopic surgery (VATS) under nonintubated, intravenous anesthesia with spontaneous ventilation and no placement of chest tube postoperatively. Journal of Thoracic Disease 8: 2226–2232. doi: 10.21037/jtd.2016.08.02 27621880
32. Pompeo E, Tacconi F, Mineo TC (2011) Comparative results of non-resectional lung volume reduction performed by awake or non-awake anesthesia. European Journal of Cardio-thoracic Surgery 39: e51–e58. doi: 10.1016/j.ejcts.2010.11.071 21397783
33. Tacconi F, Pompeo E, Sellitri F, Mineo TC (2010) Surgical stress hormones response is reduced after awake videothoracoscopy. Interact Cardiovasc Thorac Surg 10: 666–671. doi: 10.1510/icvts.2009.224139 20179134
34. AlGhamdi ZM, Lynhiavu L, Moon YK, Moon MH, Ahn S, et al. (2018) Comparison of non-intubated versus intubated video-assisted thoracoscopic lobectomy for lung cancer. J Thorac Dis 10: 4236–4243. doi: 10.21037/jtd.2018.06.163 30174869
35. Guo Z, Yin W, Zhang X, Xu X, Liu H, et al. (2016) Primary spontaneous pneumothorax: simultaneous treatment by bilateral non-intubated videothoracoscopy. Interact Cardiovasc Thorac Surg 23: 196–201. doi: 10.1093/icvts/ivw123 27165732
36. Hsiao CH, Chen KC, Chen JS (2017) Modified single-port non-intubated video-assisted thoracoscopic decortication in high-risk parapneumonic empyema patients. Surg Endosc 31: 1719–1727. doi: 10.1007/s00464-016-5164-7 27519590
37. Irons JF, Miles LF, Joshi KR, Klein AA, Scarci M, et al. (2017) Intubated Versus Nonintubated General Anesthesia for Video-Assisted Thoracoscopic Surgery-A Case-Control Study. J Cardiothorac Vasc Anesth 31: 411–417. doi: 10.1053/j.jvca.2016.07.003 27692903
38. Jeon CS, Yoon DW, Moon SM, Shin S, Cho JH, et al. (2018) Non-intubated video-assisted thoracoscopic lung biopsy for interstitial lung disease: a single-center experience. J Thorac Dis 10: 3262–3268. doi: 10.21037/jtd.2018.05.144 30069322
39. Lan L, Cen Y, Zhang C, Qiu Y, Ouyang B (2018) A Propensity Score-Matched Analysis for Non-Intubated Thoracic Surgery. Med Sci Monit 24: 8081–8087. doi: 10.12659/MSM.910605 30415268
40. McDonald CM, Pierre C, de Perrot M, Darling G, Cypel M, et al. (2018) Efficacy and Cost of Awake Thoracoscopy and Video-Assisted Thoracoscopic Surgery in the Undiagnosed Pleural Effusion. Ann Thorac Surg 106: 361–367. doi: 10.1016/j.athoracsur.2018.02.044 29577922
41. Mineo TC, Pompeo E, Mineo D, Tacconi F, Marino M, et al. (2006) Awake nonresectional lung volume reduction surgery. Ann Surg 243: 131–136. doi: 10.1097/01.sla.0000182917.39534.2c 16371748
42. Mineo TC, Sellitri F, Tacconi F, Ambrogi V (2014) Quality of life and outcomes after nonintubated versus intubated video-thoracoscopic pleurodesis for malignant pleural effusion: comparison by a case-matched study. J Palliat Med 17: 761–768. doi: 10.1089/jpm.2013.0617 24773212
43. Noda M, Okada Y, Maeda S, Sado T, Sakurada A, et al. (2012) Is there a benefit of awake thoracoscopic surgery in patients with secondary spontaneous pneumothorax? J Thorac Cardiovasc Surg 143: 613–616. doi: 10.1016/j.jtcvs.2011.07.067 22104684
44. Tacconi F, Pompeo E, Fabbi E, Mineo TC (2010) Awake video-assisted pleural decortication for empyema thoracis. Eur J Cardiothorac Surg 37: 594–601. doi: 10.1016/j.ejcts.2009.08.003 19762250
45. Tacconi F, Pompeo E, Mineo TC (2009) Duration of air leak is reduced after awake nonresectional lung volume reduction surgery. European Journal of Cardio-thoracic Surgery 35: 822–828. doi: 10.1016/j.ejcts.2009.01.010 19233672
46. Liang H, Liu J, Wu S, Zhang Y, Liu H, et al. (2019) Non-intubated spontaneous ventilation offers better short term outcome for mediastinal tumor surgery. Ann Thorac Surg.
47. Tonnesen E, Hohndorf K, Lerbjerg G, Christensen NJ, Huttel MS, et al. (1993) Immunological and hormonal responses to lung surgery during one-lung ventilation. Eur J Anaesthesiol 10: 189–195. 8495681
48. De Conno E, Steurer MP, Wittlinger M, Zalunardo MP, Weder W, et al. (2009) Anesthetic-induced improvement of the inflammatory response to one-lung ventilation. Anesthesiology 110: 1316–1326. doi: 10.1097/ALN.0b013e3181a10731 19417610
49. Kozian A, Schilling T, Freden F, Maripuu E, Rocken C, et al. (2008) One-lung ventilation induces hyperperfusion and alveolar damage in the ventilated lung: an experimental study. Br J Anaesth 100: 549–559. doi: 10.1093/bja/aen021 18308740
50. Howard-Quijano K, Takamiya T, Dale EA, Yamakawa K, Zhou W, et al. (2017) Effect of Thoracic Epidural Anesthesia on Ventricular Excitability in a Porcine Model. Anesthesiology 126: 1096–1106. doi: 10.1097/ALN.0000000000001613 28358748
51. Vollmer C, Nommensen J, Watolla M, Bauer I, Picker O (2016) Influence of thoracic epidural anesthesia on gastric oxygenation during hypothermia and hemorrhage. Auton Neurosci 195: 1–7. doi: 10.1016/j.autneu.2016.01.004 26905213
52. Trejo Bittar HE, Doberer D, Mehrad M, Strollo DC, Leader JK, et al. (2017) Histologic Findings of Severe/Therapy-Resistant Asthma From Video-assisted Thoracoscopic Surgery Biopsies. Am J Surg Pathol 41: 182–188. doi: 10.1097/PAS.0000000000000777 28079597
53. Matsuoka K, Kuroda A, Kang A, Imanishi N, Nagai S, et al. (2013) Surgical results of video-assisted thoracic surgery and risk factors for prolonged hospitalization for secondary pneumothorax in elderly patients. Ann Thorac Cardiovasc Surg 19: 18–23. doi: 10.5761/atcs.oa.12.01909 22971717
54. Papadima A, Boutsikou M, Lagoudianakis EE, Kataki A, Konstadoulakis M, et al. (2009) Lymphocyte apoptosis after major abdominal surgery is not influenced by anesthetic technique: a comparative study of general anesthesia versus combined general and epidural analgesia. J Clin Anesth 21: 414–421. doi: 10.1016/j.jclinane.2008.10.015 19833274
55. Velcic Brumnjak S, Rakovac I, Papez Kinkela D, Bukal K, Sestan B, et al. (2018) Postoperative Regional Analgesia Is Effective in Preserving Perforin-Expressing Lymphocytes in Patients After Total Knee Replacement. Med Sci Monit 24: 5320–5328. doi: 10.12659/MSM.909385 30063033
56. Zhang K, Chen HG, Wu WB, Li XJ, Wu YH, et al. (2019) Non-intubated video-assisted thoracoscopic surgery vs. intubated video-assisted thoracoscopic surgery for thoracic disease: a systematic review and meta-analysis of 1,684 cases. J Thorac Dis 11: 3556–3568. doi: 10.21037/jtd.2019.07.48 31559062
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