Spontaneous ventilation anesthesia combined with uniportal and tubeless thoracoscopic sympathectomy in selected patients with primary palmar hyperhidrosis
Abstract Background To assess the feasibility and safety of tubeless video-assisted thoracoscopic sympathectomy (VATS) with a single 5 mm port under nonintubated, intravenous anesthesia with spontaneous ventilation in selected patients with primary palmar hyperhidrosis (PPH). Methods Adults (aged be...
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| Format: | Article |
| Language: | English |
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BMC
2022-07-01
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| Series: | Journal of Cardiothoracic Surgery |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13019-022-01917-4 |
| _version_ | 1818510666745511936 |
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| author | Guang-Qiang Shao Da-Zhi Pang Ji-Tian Zhang Hong-Xia Wang Tai-Yang Liuru Zhi-Hai Liu Ya-Nan Liang Jing-Si Liu |
| author_facet | Guang-Qiang Shao Da-Zhi Pang Ji-Tian Zhang Hong-Xia Wang Tai-Yang Liuru Zhi-Hai Liu Ya-Nan Liang Jing-Si Liu |
| author_sort | Guang-Qiang Shao |
| collection | DOAJ |
| description | Abstract Background To assess the feasibility and safety of tubeless video-assisted thoracoscopic sympathectomy (VATS) with a single 5 mm port under nonintubated, intravenous anesthesia with spontaneous ventilation in selected patients with primary palmar hyperhidrosis (PPH). Methods Adults (aged between 18 and 60 years) with moderate or severe PPH symptoms were enrolled. Demographic information and clinical data were obtained from 172 consecutive patients undergoing thoracoscopic surgery for PPH from March 2014 to December 2020. The primary outcomes were the rate of complications, including death, and the intraoperative conversion rate to 3-port VATS. The secondary outcomes were the conversion rate to intubated anesthesia during the operation and the surgical duration and pain score of postoperative day 0. Results In total, 172 patients were included with 88 males and 84 females. The median age was was 25 years (IQR:21–30 years). No mortalities or major morbidities occurred in any patient. The overall median surgical duration was 53 min (IQR:37–72 min). The median length of postoperative hospital stay was one day (IQR:one–one day). The median pain score of POD0 was 2 (IQR:2–2). Intraoperative conversion to 3-port VATS followed by drainage tube insertion occurred in one (0.6%) patient due to extensive pleural adhesions. No patients required conversion to intubated anesthesia during surgery. No postoperative mechanical ventilation was noted in any patient. Conclusions For selected patients with PPH, tubeless VATS with a single 5 mm port using spontaneous ventilation anesthesia can be considered a feasible and safe operation. The surgical wound is extremely small and the operation time is shorter than the conventional technique. Trial registration This study was in conformity with the Declaration of Helsinki, and was approved by the National Ethics Committee of the University of the Hong Kong-Shenzhen Hospital (Approval number: [2020]70). We registered the study in the Chinese Clinical Trial Registry (Registration number: ChiCTR2100049063) in 2021.Informed consent was collected from all the participants of this study. URL for this clinical trial registration is: https://www.chictr.org.cn/index.aspx . |
| first_indexed | 2024-12-10T23:23:04Z |
| format | Article |
| id | doaj.art-773184d6f2d94b648d33e4a9ffe36848 |
| institution | Directory Open Access Journal |
| issn | 1749-8090 |
| language | English |
| last_indexed | 2024-12-10T23:23:04Z |
| publishDate | 2022-07-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Cardiothoracic Surgery |
| spelling | doaj.art-773184d6f2d94b648d33e4a9ffe368482022-12-22T01:29:39ZengBMCJournal of Cardiothoracic Surgery1749-80902022-07-011711810.1186/s13019-022-01917-4Spontaneous ventilation anesthesia combined with uniportal and tubeless thoracoscopic sympathectomy in selected patients with primary palmar hyperhidrosisGuang-Qiang Shao0Da-Zhi Pang1Ji-Tian Zhang2Hong-Xia Wang3Tai-Yang Liuru4Zhi-Hai Liu5Ya-Nan Liang6Jing-Si Liu7Division of Thoracic Surgery, Department of Surgery, The University of Hong Kong-Shenzhen HospitalDivision of Thoracic Surgery, Department of Surgery, The University of Hong Kong-Shenzhen HospitalDivision of Thoracic Surgery, Department of Surgery, The University of Hong Kong-Shenzhen HospitalDivision of Respiratory and Critical Care Medicine, The University of Hong Kong-Shenzhen HospitalDivision of Thoracic Surgery, Department of Surgery, The University of Hong Kong-Shenzhen HospitalDivision of Thoracic Surgery, Department of Surgery, The University of Hong Kong-Shenzhen HospitalDivision of Thoracic Surgery, Department of Surgery, The University of Hong Kong-Shenzhen HospitalDivision of Pediatric Surgery, Department of Surgery, The University of Hong Kong-Shenzhen HospitalAbstract Background To assess the feasibility and safety of tubeless video-assisted thoracoscopic sympathectomy (VATS) with a single 5 mm port under nonintubated, intravenous anesthesia with spontaneous ventilation in selected patients with primary palmar hyperhidrosis (PPH). Methods Adults (aged between 18 and 60 years) with moderate or severe PPH symptoms were enrolled. Demographic information and clinical data were obtained from 172 consecutive patients undergoing thoracoscopic surgery for PPH from March 2014 to December 2020. The primary outcomes were the rate of complications, including death, and the intraoperative conversion rate to 3-port VATS. The secondary outcomes were the conversion rate to intubated anesthesia during the operation and the surgical duration and pain score of postoperative day 0. Results In total, 172 patients were included with 88 males and 84 females. The median age was was 25 years (IQR:21–30 years). No mortalities or major morbidities occurred in any patient. The overall median surgical duration was 53 min (IQR:37–72 min). The median length of postoperative hospital stay was one day (IQR:one–one day). The median pain score of POD0 was 2 (IQR:2–2). Intraoperative conversion to 3-port VATS followed by drainage tube insertion occurred in one (0.6%) patient due to extensive pleural adhesions. No patients required conversion to intubated anesthesia during surgery. No postoperative mechanical ventilation was noted in any patient. Conclusions For selected patients with PPH, tubeless VATS with a single 5 mm port using spontaneous ventilation anesthesia can be considered a feasible and safe operation. The surgical wound is extremely small and the operation time is shorter than the conventional technique. Trial registration This study was in conformity with the Declaration of Helsinki, and was approved by the National Ethics Committee of the University of the Hong Kong-Shenzhen Hospital (Approval number: [2020]70). We registered the study in the Chinese Clinical Trial Registry (Registration number: ChiCTR2100049063) in 2021.Informed consent was collected from all the participants of this study. URL for this clinical trial registration is: https://www.chictr.org.cn/index.aspx .https://doi.org/10.1186/s13019-022-01917-4Nonintubated VATSSingle 5 mm portSympathectomySpontaneous ventilation anesthesia (SVA)TubelessPrimary palmar hyperhidrosis (PPH) |
| spellingShingle | Guang-Qiang Shao Da-Zhi Pang Ji-Tian Zhang Hong-Xia Wang Tai-Yang Liuru Zhi-Hai Liu Ya-Nan Liang Jing-Si Liu Spontaneous ventilation anesthesia combined with uniportal and tubeless thoracoscopic sympathectomy in selected patients with primary palmar hyperhidrosis Journal of Cardiothoracic Surgery Nonintubated VATS Single 5 mm port Sympathectomy Spontaneous ventilation anesthesia (SVA) Tubeless Primary palmar hyperhidrosis (PPH) |
| title | Spontaneous ventilation anesthesia combined with uniportal and tubeless thoracoscopic sympathectomy in selected patients with primary palmar hyperhidrosis |
| title_full | Spontaneous ventilation anesthesia combined with uniportal and tubeless thoracoscopic sympathectomy in selected patients with primary palmar hyperhidrosis |
| title_fullStr | Spontaneous ventilation anesthesia combined with uniportal and tubeless thoracoscopic sympathectomy in selected patients with primary palmar hyperhidrosis |
| title_full_unstemmed | Spontaneous ventilation anesthesia combined with uniportal and tubeless thoracoscopic sympathectomy in selected patients with primary palmar hyperhidrosis |
| title_short | Spontaneous ventilation anesthesia combined with uniportal and tubeless thoracoscopic sympathectomy in selected patients with primary palmar hyperhidrosis |
| title_sort | spontaneous ventilation anesthesia combined with uniportal and tubeless thoracoscopic sympathectomy in selected patients with primary palmar hyperhidrosis |
| topic | Nonintubated VATS Single 5 mm port Sympathectomy Spontaneous ventilation anesthesia (SVA) Tubeless Primary palmar hyperhidrosis (PPH) |
| url | https://doi.org/10.1186/s13019-022-01917-4 |
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