ArticleJournal of visualized surgery2026
Non-intubated video-assisted thoracic surgery with an integrated postoperative strategy for secondary spontaneous pneumothorax in high-risk patients.
Article in Journal of visualized surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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1 citing paper in PubMed.
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3 authors.
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No grant is acknowledged in the PubMed record.
Abstract
Background: Non-intubated video-assisted thoracic surgery (VATS) is an option for the treatment of secondary spontaneous pneumothorax (SSP) in high-risk patients. Although persistent air leakage remains a major postoperative challenge, the efficacy of subsequent treatment to arrest such leakage has not been fully clarified. This study aimed to describe the surgical procedures and postoperative management of non-intubated VATS and to evaluate treatment outcomes. Methods: A single-center retrospective study was conducted on patients who underwent non-intubated VATS for intractable SSP between 2011 and 2021. All patients were considered intolerant to surgery under general anesthesia with endotracheal intubation. The air-leak sites were managed with ligation or pleural coverage. Postoperative pleurodesis was performed to terminate air leakage or to prevent pneumothorax recurrence. Results: Twenty-one patients were included in the study. The mean age was 78.3±8.4 years. Air leakage was treated by ligation in 10 patients (48%). Postoperative air leakage occurred in 11 patients (52%). Twenty patients underwent pleurodesis. Air leakage was arrested by surgery alone or by surgery combined with pleurodesis in 16 patients (76%), and ultimately in 19 patients (90%), including three who required bronchial occlusion. Six patients (29%) died during hospitalization. Postoperative recurrence of pneumothorax was observed in two patients (11%). The 1- and 2-year overall survival rates were 47% and 35%, respectively. Conclusions: Postoperative air leakage was common after non-intubated VATS for SSP. However, non-surgical interventions effectively controlled air leakage in most cases. The high in-hospital mortality rate likely reflected the patients' poor physical condition and the severity of their underlying diseases. Non-intubated VATS combined with postoperative pleurodesis or bronchial occlusion is an alternative for patients with persistent air leakage who are poor candidates for surgery under general anesthesia. Further studies are required to assess the validity of this procedure.
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