NON-INTUBATED SINGLE-PORT VIDEO-ASSISTED THORACIC SURGERY IN PATIENTS WITH PLEURAL EFFUSION AND POOR PERFORMANCE STATUS

Abstract

Objective: To determine the safety and efficacy of its application in patients treated at the Clinic of Thoracic Surgery, University Multiprofile Hospital for Active Treatment “Prof. Dr. Stoyan Kirkovich” AD, Stara Zagora through a retrospective analysis of patients who underwent Non-intubated Single-port Video-Assisted Thoracic Surgery (SVATS). Materials and Methods: For the period from 01.01.2021 to 28.02.2025, a total of 1436 patients with pleural effusions (PE) were treated at the Clinic of Thoracic Surgery. The surgical procedures performed included intrapleural drainage, conventional VATS under general intubation anesthesia, and SVATS under non-intubated anesthesia combined with local anesthesia. In order to prevent recurrent PE, pleurectomy, decortication, talc or povidone-iodine pleurodesis were performed, as well as placement of a prolonged thoracostomy catheter. Results: The mean patient age was 68 years. Of the 1436 patients, 674 underwent VATS procedures. Among them, 143 underwent intubated conventional VATS, while the remaining 531 underwent non-intubated SVATS. Postoperative pain was significantly lower in patients who underwent non-intubated SVATS compared to those who underwent conventional VATS. Conclusions: Non-intubated SVATS is a safe and minimally invasive procedure, especially in patients with severe general condition, poor performance status, and significant comorbidities.