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Case Reports
. 2017 Apr 10:3:48.
doi: 10.21037/jovs.2017.03.12. eCollection 2017.

Non-intubated uniportal left-lower lobe upper segmentectomy (S6)

Carlos Galvez  1 , Jose Navarro-Martinez  2 , Sergio Bolufer  1 , Julio Sesma  1 , Francisco Lirio  1 , Maria Galiana  2 , Maria Jesus Rivera  2
Affiliations
Case Reports

Non-intubated uniportal left-lower lobe upper segmentectomy (S6)

Carlos Galvez et al. J Vis Surg. .

Abstract

Worldwide accepted indications of anatomical segmentectomies are mainly early stage primary adenocarcinomas, pulmonary metastasis and benign conditions. Their performance through uniportal VATS has become more and more popular due to the less invasiveness of the whole procedure under this approach. Recently, many efforts have focused on non-intubated spontaneously breathing management of lobectomies and anatomical segmentectomies, although specific selection criteria and main advantages are not completely standardized. In a 62-year-old thin man with two pulmonary residual metastasis from sigma adenocarcinoma, after chemotherapy plus antiangiogenic treatment, we indicated a single-incision video-assisted left-lower lobe (LLL) upper segmentectomy (S6) under spontaneous breathing and intercostal blockade. Total operation time was 240 minutes. Chest tube was removed at 24 hours and the patient was discharge on postoperative day 2 without any complication. Non-intubated uniportal VATS is a safe and reasonable approach for lung-sparing resections in selected patients, although more evidence is required for selecting which patients can benefit more over standard intubated procedures.

Keywords: Thoracoscopy/VATS; anesthesia; lung cancer surgery.

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Conflict of interest statement

Conflicts of Interest: The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
15-mm central metastasis of intestinal adenocarcinoma in the upper segment (S6) of the left-lower lobe.
Figure 2
Figure 2
Video-assisted intercostal blockades with Bupivacaine (9). Available online: http://www.asvide.com/articles/1442
Figure 3
Figure 3
Video-assisted vagal blockade with Bupivacaine (10). Available online: http://www.asvide.com/articles/1443
Figure 4
Figure 4
Anatomical upper segmentectomy of the left lower lobe through uniportal VATS in a spontaneously breathing patient (11). Available online: http://www.asvide.com/articles/1444
Figure 5
Figure 5
Postoperative chest X-ray at 48 hours.
See this image and copyright information in PMC

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