Comparative analysis of safety and outcomes of Non-intubated versus intubated uniportal video-assisted thoracic surgery using propensity score matching: a single-center experience expanding indications beyond traditional restrictions - Summary - MDSpire
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Comparative analysis of safety and outcomes of Non-intubated versus intubated uniportal video-assisted thoracic surgery using propensity score matching: a single-center experience expanding indications beyond traditional restrictions
To evaluate perioperative outcomes of non-intubated uniportal video-assisted thoracoscopic surgery (NI-UVATS) compared to intubated UVATS (I-UVATS) in a diverse patient population, focusing on safety and feasibility.
Key Findings:
After matching, 98 patients in each group were analyzed.
Serious complications occurred in 10.8% I-UVATS vs. 7.4% NI-UVATS for low-complexity procedures (p = 0.545).
Operative time was longer in NI-UVATS (median 52 vs. 37 min, p = 0.042).
Overall serious complications were 14.3% I-UVATS vs. 11.2% NI-UVATS (p = 0.522).
Thirty-day mortality was 12.2% in I-UVATS vs. 7.1% in NI-UVATS (p = 0.240).
Interpretation:
NI-UVATS demonstrated safety and feasibility for low-to-medium complexity thoracic procedures, though significant procedural imbalance exists, indicating a need for careful patient selection.
Limitations:
Significant procedural heterogeneity persisted despite matching, which may affect the generalizability of the results.
Limited number of NI-UVATS anatomical resections precluded meaningful comparison for high-complexity procedures.
The study was retrospective and conducted at a single center, which may introduce bias.
Conclusion:
NI-UVATS is safe for selected patients undergoing diagnostic and pleural procedures, but anatomical resections are primarily performed under intubation. Further randomized trials are needed to better define the role of NI-UVATS in complex resections.
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