Awake VATS can be safe option for some lung cancer patients

(HealthDay)—Awake video-assisted thoracoscopic surgery (AVATS) is a safe and feasible technique for patients with poor lung function and lung cancer, according to a study presented recently at the annual meeting of the American Association for Thoracic Surgery, held from April 28 to May 1 in San Diego.

Ara Klijian, M.D., from Sharp Grossmont Hospital in La Mesa, Calif., described outcomes for 246 patients with lung cancer who underwent AVATS.

The researchers found that the length of stay for lobectomy via AVATS was 1.6 days, even in patients with a forced expiratory volume in one second (FEV1) under 0.6. Multiple comorbidities were reported in these patients, including diabetes, chronic obstructive pulmonary disease, atrial fibrillation, hypertension, and hepatic and/or renal dysfunction. Two hundred three of the 246 patients undergoing resection had FEV1 <0.8. In order to minimize nosocomial infections, postoperative care was streamlined to minimize central line and arterial, urinal, and epidural catheter use. Better patient satisfaction was reported with AVATS.

"By eliminating the need for endotracheal intubation and the comorbidity associated with general anesthesia, the AVATS procedure brings new, previously considered inoperable patients into the surgical arena," Klijian said in a statement. "My long-term data have shown that this approach has better outcomes than traditional lung surgery with this select group of patients. It also reduces risks of hospital-acquired infection, as outpatient postoperative care minimizes the use of catheters."