电视辅助胸腔镜(VATS)技术的引入为胸外科手术提供了新的方法。VATS是通过胸壁的小切口插入胸腔镜来进行的,从而最大限度地保护肌肉和组织。由于其发病率和死亡率低,VATS目前是大多数胸部手术的首选技术。VATS肺切除术减少了长时间的漏气,心律失常,肺炎,术后疼痛和炎症标志物。术后并发症的减少缩短了住院时间,特别适用于对开胸手术耐受性低的高危患者。与传统开胸手术相比,VATS手术的肿瘤学结果与开放手术相似甚至优于开放手术。这个多学科立场声明的目标是由西班牙麻醉与复活学会(SEDAR)的胸外科工作组制作的,西班牙胸外科学会(SECT),西班牙物理治疗协会(AEF)将为接受VATS肺切除术的患者标准化和传播一系列围手术期麻醉管理指南。每个建议都是基于作者对现有文献的深入审查。在这份文件中,接受VATS手术的患者的护理是分段组织的,从手术方法开始,其次是麻醉管理的三大支柱:术前,术中,和术后麻醉。
The introduction of video-assisted thoracoscopic (VATS) techniques has led to a new approach in thoracic surgery. VATS is performed by inserting a thoracoscope through a small incisions in the chest wall, thus maximizing the preservation of muscle and tissue. Because of its low rate of morbidity and mortality, VATS is currently the technique of choice in most thoracic procedures. Lung resection by VATS reduces prolonged air leaks, arrhythmia, pneumonia, postoperative pain and inflammatory markers. This reduction in postoperative complications shortens hospital length of stay, and is particularly beneficial in high-risk patients with low tolerance to thoracotomy. Compared with conventional thoracotomy, the oncological results of VATS surgery are similar or even superior to those of open surgery. This aim of this multidisciplinary position statement produced by the thoracic surgery working group of the Spanish Society of Anesthesiology and Reanimation (SEDAR), the Spanish Society of Thoracic Surgery (SECT), and the Spanish Association of Physiotherapy (AEF) is to standardize and disseminate a series of perioperative anaesthesia management guidelines for patients undergoing VATS lung resection surgery. Each recommendation is based on an in-depth review of the available literature by the authors. In this document, the care of patients undergoing VATS surgery is organized in sections, starting with the surgical approach, and followed by the three pillars of anaesthesia management: preoperative, intraoperative, and postoperative anaesthesia.