Comparison of awake and intubaded VATS methods in interstitial lung diseases in terms of hospital stay

BACKGROUND This study aims to explain the effectiveness of awake video-assisted thoracoscopic surgery (VATS) in diagnostic thoracic surgery by comparing patients who underwent surgery for interstitial lung disease (ILD) using VATS under general anesthesia and intubation with those who underwent surgery using the awake VATS method under epidural anesthesia. METHODS Patients who underwent surgery with VATS procedure for ILD and interstitial pulmonary fibrosis (IPF) (n = 100) were analyzed retrospectively. The study only included patients who were scheduled to undergo diagnostic VATS. Their operation times, postoperative intensive care unit follow-up times, drain termination times, and total hospital stays were compared, and the diagnostic success was evaluated. RESULTS Of the 100 patients who underwent surgery for idiopathic arterial hypertension (IAH), 52 (52%) underwent with awake VATS and 48 (48%) underwent conventional VATS. Preoperative demographic and clinical data of the patients were examined. No statistically significant differences were observed in the preoperative evaluations of the patients. The average length of surgery was 90 minutes (range 45–140 minutes) for awake VATS and 117.5 minutes (range 69–285 minutes) for intubated VATS. The average length of stay in the postoperative intensive care unit in the awake VATS group was 6.0 hours (4.0-25.0), which was statistically significant (p < 0.001). Atelectasis was significantly less common in the early postoperative chest radiographs of patients who underwent awake VATS (p ˂ 0.001). CONCLUSION The results of our study showed that awake VATS is an effective and reliable method for diagnostic thoracic surgery operations. Patients who undergo awake VATS are operated on and discharged faster, and the procedure is completed at a lower cost.