Korean Journal of Thoracic and Cardiovascular Surgery 2018; 51(5): 344-349  
Nonintubated Uniportal Video-Assisted Thoracoscopic Surgery: A Single-Center Experience
Seha Ahn, M.D.1, Youngkyu Moon, M.D., Ph.D.1, Zeead M. AlGhamdi, M.D.1,2
Sook Whan Sung, M.D., Ph.D.1
1Department of Thoracic and Cardiovascular Surgery, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 
2Department of Surgery, College of Medicine, Imam Abdulrahman Bin Faisal University
Corresponding author: Sook Whan Sung, Department of Thoracic and Cardiovascular Surgery, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul 06591, Korea
(Tel) 82-2-2258-2858 (Fax) 82-2-594-8644 (E-mail) swsung@catholic.ac.kr
Received: November 13, 2017; Revised: January 29, 2018; Accepted: January 29, 2018.; Published online: October 5, 2018.
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Background: We report our surgical technique for nonintubated uniportal video-assisted thoracoscopic surgery (VATS) pulmonary resection and early postoperative outcomes at a single center. Methods: Between January and July 2017, 40 consecutive patients underwent nonintubated uniportal VATS pulmonary resection. Multilevel intercostal nerve block was performed using local anesthesia in all patients, and an intrathoracic vagal blockade was performed in 35 patients (87.5%). Results: Twenty-nine procedures (72.5%) were performed in patients with lung cancer (21 lobectomies, 6 segmentectomies, and 2 wedge resections), and 11 (27.5%) in patients with pulmonary metastases, benign lung disease, or pleural disease. The mean anesthesia time was 166.8 minutes, and the mean operative duration was 125.9 minutes. The mean postoperative chest tube duration was 3.2 days, and the mean hospital stay was 5.8 days. There were 3 conversions (7.5%) to intubation due to intraoperative hypoxemia and 1 conversion (2.5%) to multiportal VATS due to injury of the segmental artery. There were 7 complications (17.5%), including 3 cases of prolonged air leak, 2 cases of chylothorax, 1 case of pleural effusion, and 1 case of pneumonia. There was no in-hospital mortality. Conclusion: Nonintubated uniportal VATS appears to be a fea
Keywords: Nonintubated; Uniportal; Thoracic surgery; Minimally invasive surgical procedures

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