Original article: general thoracicFeasibility and Results of Awake Thoracoscopic Resection of Solitary Pulmonary Nodules
Section snippets
Material and Methods
The study was started in March 2001 and was closed in February 2003. Written informed consent was obtained from all patients who took part and the study was approved by the institutional review board of the Tor Vergata University. Sixty patients with undetermined solitary pulmonary nodule, who met the entry criteria, were randomized by computer into two groups: 30 patients underwent VATS resection of the pulmonary nodule under conventional general anesthesia with one-lung ventilation. Thirty
Results
During the study period, 12 of 72 eligible patients refused to accept the randomization and were excluded from the analysis. Of these, 8 patients asked to undergo the awake procedure while 4 preferred general anesthesia. Table 1 shows that the two study groups were well matched in terms of base line characteristics and measures. Overall, the nodules were localized in the right upper, middle or right lower lobe in 22, 7, and 10 instances, respectively; in the left upper or lower lobe in 11 and
Comment
Selected controlled ventilation came with the introduction of the double-lumen endobronchial tube introduced by Zavod in 1940 [9] and refined by Carlens in 1949 [10]. It proved to be a revolutionary advance in thoracic surgery and is now the standard type of anesthesia for both open and VATS pulmonary resections. However, despite some indisputable and well-known advantages, several adverse effects can derive from this type of anesthesia including an increased risk of pneumonia, impaired cardiac
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