@article{JTD125605,
author = {Hayan Merhej and Alaa Selman and Daniel Benjamin Jaeger and Jan Karsten and Alina Meininger and Dietmar Boethig and Akylbek Saipbaev and Mihail Magdei and Tomoyuki Nakagiri and Norman Zinne and Arjang Ruhparwar and Ruoyu Zhang and Felix Lennartz and Heiko Golpon and Patrick Zardo},
title = {Non-intubated uniportal video-assisted minor and major pulmonary resections: a single-center European experience in 163 selected patients},
journal = {Journal of Thoracic Disease},
volume = {0},
number = {0},
year = {2026},
keywords = {},
abstract = {Background: Non-intubated video-assisted thoracoscopic surgery (niVATS) avoids endotracheal intubation and one-lung mechanical ventilation. Whether this translates into clinically meaningful benefits compared with intubated video-assisted thoracoscopic surgery (VATS) requires comparative studies. Evidence from European centers, particularly for major pulmonary resections, remains limited. We evaluated technical feasibility and perioperative outcomes in a selected European niVATS cohort.Methods: This retrospective single-center observational study included consecutive patients selected to undergo niVATS between May 2018 and February 2025. The primary endpoint was intraoperative conversion to intubated anesthesia. Secondary endpoints included postoperative complications, chest tube duration, length of stay, reoperation, and 30-day mortality.Results: A total of 163 patients were included. Median age was 67 years and median body mass index (BMI) was 24 kg/m2. Anatomical lung resections were performed in 77 patients (47.2%), including 50 lobectomies and 27 segmentectomies. Conversion to intubated anesthesia occurred in 6 patients (3.7%). Prolonged air leak was observed in 21 patients (12.9%), pneumonia in 5 (3.1%), and reoperation in 6 (3.7%). Thirty-day mortality was 1.2%. Median chest tube duration and hospital stay were 3 and 5 days, respectively. Conversion was more frequently observed among patients undergoing lobectomy and among those with a higher BMI.Conclusions: niVATS is feasible in selected patients across a broad spectrum of thoracic procedures in a high-volume European center. Lobectomy and increasing BMI are associated with a higher likelihood of conversion and should be considered during patient selection and perioperative planning. These descriptive findings do not establish comparative safety or clinical benefit versus intubated VATS; prospective comparative studies are required.},
issn = {2077-6624}, url = {https://jtd.amegroups.org/article/view/125605}
}