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Chinese Journal of Clinicians(Electronic Edition) ›› 2020, Vol. 14 ›› Issue (06): 452-455. doi: 10.3877/cma.j.issn.1674-0785.2020.06.011

Special Issue:

• Clinical Research • Previous Articles     Next Articles

Application of single-port video-assisted thoracoscopy in emergency thoracic surgery during novel coronavirus pneumonia pandemic: advantages and perioperative management

Liqun Shang1,(), Shaolu Zhang1, Zhigang Qu1, Guang Wu1   

  1. 1. Thoracic Surgery Department, Zhuozhou City Hospital, Zhuozhou 072750, China
  • Received:2020-02-29 Online:2020-06-15 Published:2020-06-15
  • Contact: Liqun Shang
  • About author:
    Corresponding author: Shang Liqun, Email:

Abstract:

Objective

To discuss the advantages and perioperative management of single-port video-assisted thoracoscopic surgery (SPVATS) during the novel coronavirus pneumonia (COVID-19) pandemic.

Methods

The characteristics and key points of diagnosis and treatment of six cases of emergency SPVATS performed from January to February 2020 at Zhuozhou City Hospital were analyzed retrospectively. Preoperative screening, protection in operation room, anesthesia, perioperative management, and the advantages of SPVATS were summarized.

Results

Screening CT and routine blood test results were all negative in six patients before operation, and no COVID-19 virus infection was finally detected after operation. Emergency operation was prepared considering the presence of infection. The anesthesia and operation process were shortened as much as possible. All cases were operated by SPVATS. Another set of aspirator was used to strengthen the smoke gas suction, which significantly reduced the formation of smoke or aerosol in the chest cavity. One case underwent bronchopulmonary repair, four cases underwent partial pneumonectomy, of which two cases with rib fracture underwent thoracoscopic assisted rib fixation, and one case underwent SPVATS lobectomy with double lumen endotracheal intubation under general anesthesia. The average postoperative hospital stay was 5.8 days. No serious complications occurred. However, the cost of the treatment increased by about 30% on average.

Conclusion

SPVATS has the characteristics of minimal invasion and good smoke sealing, which is suitable for emergency operation during the epidemic period. The prevention and treatment in the perioperative period should be strengthened. Even if patients have negative results of preoperative screening CT and routine blood test, they should be treated as potentially infected patients.

Key words: Novel coronavirus pneumonia, Single-port video-assisted thoracoscopic surgery, Perioperative management

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