临床外科杂志 ›› 2025, Vol. 33 ›› Issue (9): 1003-1006.doi: 10.3969/j.issn.1005-6483.20241744

• 综述与讲座 • 上一篇    下一篇

非插管视频辅助胸腔镜手术在非小细胞肺癌中的应用进展

程辉 李樊 赵波   

  1. 430030 湖北武汉,华中科技大学同济医学院附属同济医院胸外科
  • 收稿日期:2024-10-29 出版日期:2025-10-16 发布日期:2025-10-16
  • 通讯作者: 赵波,Email:13006369600@163.com

Progress in the application of non-intubated video-assisted thoracoscopic surgery for non-small cell lung cancer

CHENG Hui,LI Fan,ZHAO Bo   

  1. Department of Thoracic Surgery,Tongji Hospital Affiliated to Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China
  • Received:2024-10-29 Online:2025-09-20 Published:2025-10-16

摘要: 随着微创技术的进步,非插管视频辅助胸腔镜手术(NIVATS)在早期非小细胞肺癌(NSCLC)治疗中的应用逐渐增加。NIVATS通过保留病人自主呼吸,避免了机械通气和双腔气管插管相关的喉部损伤、气道水肿及肺部并发症。NIVATS适合于肺功能良好、肿瘤较小的NSCLC病人。然而,NIVATS在复杂病例中应用仍有局限,如淋巴结广泛清扫、肿瘤接近大血管以及严重胸膜粘连等,病人可能需中途转为插管麻醉。肥胖及合并严重心肺疾病的病人因呼吸功能不足,NIVATS的安全性和有效性降低。

关键词: 非插管手术;视频辅助胸腔镜手术;非小细胞肺癌

Abstract: With advances in minimally invasive techniques,non-intubated video-assisted thoracoscopic surgery (NIVATS) is increasingly applied in the treatment of early-stage non-small cell lung cancer (NSCLC).NIVATS preserves the patient's spontaneous breathing,avoiding laryngeal injury,airway edema,and pulmonary complications associated with mechanical ventilation and double-lumen endotracheal intubation,demonstrating significant advantages in postoperative recovery.Studies indicate that NIVATS is particularly suitable for NSCLC patients with good lung function and smaller tumors.However,the application of NIVATS in complex cases remains limited,such as in cases requiring extensive lymph node dissection,tumors close to major blood vessels,and severe pleural adhesions,where patients may need to switch to intubated anesthesia mid-procedure.Additionally,in obese patients or those with severe cardiopulmonary disease,the safety and efficacy of NIVATS are reduced due to inadequate respiratory function.

Key words: non-intubated surgery;video-assisted thoracoscopic surgery;non-small cell lung cancer

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