An air-locking port and high-flow nasal cannula in non-intubated uniportal video-assisted thoracic surgery for pneumothorax with pulmonary dysfunction: a case report
Abstract Background Non-intubated video-assisted thoracic surgery is a therapeutic option for intractable secondary spontaneous pneumothorax in patients who are poor candidates for surgery with endotracheal intubation under general anesthesia. However, intraoperative respiratory management in this s...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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SpringerOpen
2021-10-01
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| Series: | Surgical Case Reports |
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| Online Access: | https://doi.org/10.1186/s40792-021-01321-5 |
| _version_ | 1818688839009435648 |
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| author | Hiroya Yamagishi Yusuke Wakatsuki Toshihiko Tada Tadashi Matsukura |
| author_facet | Hiroya Yamagishi Yusuke Wakatsuki Toshihiko Tada Tadashi Matsukura |
| author_sort | Hiroya Yamagishi |
| collection | DOAJ |
| description | Abstract Background Non-intubated video-assisted thoracic surgery is a therapeutic option for intractable secondary spontaneous pneumothorax in patients who are poor candidates for surgery with endotracheal intubation under general anesthesia. However, intraoperative respiratory management in this surgery is often challenging because of hypoxia caused by surgical pneumothorax. Case presentation A 75-year-old man with idiopathic pulmonary fibrosis who had been on home oxygen therapy underwent non-intubated uniportal video-assisted thoracic surgery for intractable spontaneous pneumothorax. During the operation, oxygen was administered using a high-flow nasal cannula at a high flow rate. An air-locking port for single-incision surgery was used to minimize the inflow of air into the pleural cavity. The intrapleural air was continuously suctioned through the chest tube. The air-leak point was easily identified and closed using ligation. Oxygenation was satisfactory throughout the operation. Conclusions Non-intubated uniportal video-assisted thoracic surgery for secondary spontaneous pneumothorax with an air-locking port, continuous pleural suction, and high-flow nasal cannula may achieve satisfactory intraoperative oxygenation in patients with respiratory dysfunction. The intrapleural space can be feasible for surgical manipulation without surgical pneumothorax in non-intubated video-assisted thoracic surgery even when supplied with oxygen at a high flow rate using a high-flow nasal cannula. |
| first_indexed | 2024-12-17T12:00:35Z |
| format | Article |
| id | doaj.art-c7531d7ea3224121ba14165dcc9317a3 |
| institution | Directory Open Access Journal |
| issn | 2198-7793 |
| language | English |
| last_indexed | 2024-12-17T12:00:35Z |
| publishDate | 2021-10-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Surgical Case Reports |
| spelling | doaj.art-c7531d7ea3224121ba14165dcc9317a32022-12-21T21:49:52ZengSpringerOpenSurgical Case Reports2198-77932021-10-01711510.1186/s40792-021-01321-5An air-locking port and high-flow nasal cannula in non-intubated uniportal video-assisted thoracic surgery for pneumothorax with pulmonary dysfunction: a case reportHiroya Yamagishi0Yusuke Wakatsuki1Toshihiko Tada2Tadashi Matsukura3Department of Chest Surgery, Japanese Red Cross Fukui HospitalDepartment of Thoracic Surgery, Kyoto University Graduate School of MedicineDepartment of Respiratory Medicine, Japanese Red Cross Fukui HospitalDepartment of Chest Surgery, Japanese Red Cross Fukui HospitalAbstract Background Non-intubated video-assisted thoracic surgery is a therapeutic option for intractable secondary spontaneous pneumothorax in patients who are poor candidates for surgery with endotracheal intubation under general anesthesia. However, intraoperative respiratory management in this surgery is often challenging because of hypoxia caused by surgical pneumothorax. Case presentation A 75-year-old man with idiopathic pulmonary fibrosis who had been on home oxygen therapy underwent non-intubated uniportal video-assisted thoracic surgery for intractable spontaneous pneumothorax. During the operation, oxygen was administered using a high-flow nasal cannula at a high flow rate. An air-locking port for single-incision surgery was used to minimize the inflow of air into the pleural cavity. The intrapleural air was continuously suctioned through the chest tube. The air-leak point was easily identified and closed using ligation. Oxygenation was satisfactory throughout the operation. Conclusions Non-intubated uniportal video-assisted thoracic surgery for secondary spontaneous pneumothorax with an air-locking port, continuous pleural suction, and high-flow nasal cannula may achieve satisfactory intraoperative oxygenation in patients with respiratory dysfunction. The intrapleural space can be feasible for surgical manipulation without surgical pneumothorax in non-intubated video-assisted thoracic surgery even when supplied with oxygen at a high flow rate using a high-flow nasal cannula.https://doi.org/10.1186/s40792-021-01321-5Secondary spontaneous pneumothoraxInterstitial pneumonitisIdiopathic pulmonary fibrosisNon-intubated video-assisted thoracic surgeryUniportal video-assisted thoracic surgerySingle-incision surgery |
| spellingShingle | Hiroya Yamagishi Yusuke Wakatsuki Toshihiko Tada Tadashi Matsukura An air-locking port and high-flow nasal cannula in non-intubated uniportal video-assisted thoracic surgery for pneumothorax with pulmonary dysfunction: a case report Surgical Case Reports Secondary spontaneous pneumothorax Interstitial pneumonitis Idiopathic pulmonary fibrosis Non-intubated video-assisted thoracic surgery Uniportal video-assisted thoracic surgery Single-incision surgery |
| title | An air-locking port and high-flow nasal cannula in non-intubated uniportal video-assisted thoracic surgery for pneumothorax with pulmonary dysfunction: a case report |
| title_full | An air-locking port and high-flow nasal cannula in non-intubated uniportal video-assisted thoracic surgery for pneumothorax with pulmonary dysfunction: a case report |
| title_fullStr | An air-locking port and high-flow nasal cannula in non-intubated uniportal video-assisted thoracic surgery for pneumothorax with pulmonary dysfunction: a case report |
| title_full_unstemmed | An air-locking port and high-flow nasal cannula in non-intubated uniportal video-assisted thoracic surgery for pneumothorax with pulmonary dysfunction: a case report |
| title_short | An air-locking port and high-flow nasal cannula in non-intubated uniportal video-assisted thoracic surgery for pneumothorax with pulmonary dysfunction: a case report |
| title_sort | air locking port and high flow nasal cannula in non intubated uniportal video assisted thoracic surgery for pneumothorax with pulmonary dysfunction a case report |
| topic | Secondary spontaneous pneumothorax Interstitial pneumonitis Idiopathic pulmonary fibrosis Non-intubated video-assisted thoracic surgery Uniportal video-assisted thoracic surgery Single-incision surgery |
| url | https://doi.org/10.1186/s40792-021-01321-5 |
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