Awake videothoracoscopic anatomic lung resections for non-small cell lung cancer under thoracic paravertebral block: clinical experiences

Abstract

Background: To report our surgical experience with awake video-assisted thoracoscopic surgery (VATS) anatomical lung resections under thoracic paravertebral block (TPB) in patients with non-small cell lung cancer (NSCLC). Methods: This retrospective, single-center study included patients undergoing awake biportal VATS anatomical pulmonary resections due to NSCLC under TPB. Patients accepted the awake approach either voluntarily despite being suitable for general anesthesia (low-risk) or since they were found unsuitable for general anesthesia (high-risk). Our results were compared with literature data. Results: Twenty-nine patients (20 risky and and 9 normal patients) underwent 25 lobectomies and 4 segmentectomies. Surgery time was 110 ± 15 min. Morbidity rate was 6.78%. Mean chest tube duration was 2.2 ± 1.5 days and mean hospital stay duration was 3.4 ± 1.2 days. We obtained shorter surgery time and length of hospital stay compared to previous data. Conclusion: Biportal VATS anatomical lung resections for NSCLC can be performed safely under TPB in awake patients. TPB may result in shorter duration of operative times and length of hospital stay compared to TEA and intercostal nerve block.