{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T08:33:53Z","timestamp":1740126833936,"version":"3.37.3"},"reference-count":23,"publisher":"Georg Thieme Verlag KG","issue":"S 01","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Zentralbl Chir"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title><jats:p>\n          Einleitung Videoassistiere thorakoskopische Verfahren (VATS) unter Erhalt der Spontanatmung (NI-VATS) erleben derzeit weltweit eine Renaissance. Bisher liegen nur wenige Berichte \u00fcber die Selektion geeigneter Patienten sowie das operative und an\u00e4sthesiologische Management dieser Verfahren in Deutschland vor. In dieser Fallserie legen wir unsere bisherigen Ergebnisse und Erfahrungen zur NI-VATS dar und diskutieren die Ergebnisse anhand vorliegender Umfrageergebnisse und der verf\u00fcgbaren Literatur.<\/jats:p><jats:p>\n          Methode Retrospektive Datenerhebung aller Patienten, die in unserer Einrichtung einer NI-VATS unterzogen wurden.<\/jats:p><jats:p>\n          Ergebnisse Im Zeitraum 06\/2018 bis 1\/2020 wurden 17 (9 m\u00e4nnliche und 8 weibliche) Patienten einer NI-VATS unterzogen. Die Patienten hatten ein medianes Alter von 68 [61\u200a\u2013\u200a79] Jahren. Vierzehn Patienten hatten eine fortgeschrittene Krebserkrankung, die letztendlich zur Lungenoperation f\u00fchrte. Alle Patienten hatten schwerwiegende Nebenerkrankungen und wurden den ASA-Klassen III (n\u2009=\u20099) und IV (n\u2009=\u20098) zugeordnet. Die Operationen waren von kurzer Dauer (im Median 18 [15\u200a\u2013\u200a27] Minuten) und beinhalteten in 82% der F\u00e4lle pleurale Eingriffe (Pleurektomie, Dekortikation oder Einlage einer Thoraxdrainage). Alle Patienten tolerierten die Operation unter Lokalan\u00e4sthesie und Analgosedierung. Elf Patienten konnten postoperativ direkt \u00fcber den Aufwachraum auf die Normalstation verlegt werden, die restlichen Patienten wurden einer intensivierten postoperativen \u00dcberwachung zugef\u00fchrt. F\u00fcnf der 17 Patienten verstarben im weiteren station\u00e4ren Aufenthalt, im Median 8 [3,0\u200a\u2013\u200a33,5] Tage\n\t\t\t\t\tnach der Operation im Rahmen ihrer Grunderkrankung. Kein Todesfall konnte mit der Operationstechnik in Zusammenhang gebracht werden.<\/jats:p><jats:p>\n          Diskussion Die NI-VATS stellt bei ausgew\u00e4hlten Patienten und entsprechender Expertise vor Ort eine sichere und praktikable Alternative zur Operation in Allgemeinan\u00e4sthesie und Einlungenventilation dar. In unserer Einrichtung wurden multimorbide Patienten mit Eingriffen von kurzer Dauer und \u00fcberschaubarem Ausma\u00df der NI-VATS unterzogen und kristallisierten sich als geeignete Kandidaten f\u00fcr dieses Verfahren heraus. Neben der sorgf\u00e4ltigen Patientenselektion erscheint das (Er-)Kennen h\u00e4ufiger Komplikationen ein wichtiger Meilenstein der erfolgreichen NI-VATS zu sein.<\/jats:p>","DOI":"10.1055\/a-1263-1504","type":"journal-article","created":{"date-parts":[[2020,11,11]],"date-time":"2020-11-11T23:50:57Z","timestamp":1605138657000},"page":"S10-S18","source":"Crossref","is-referenced-by-count":0,"special_numbering":"S","title":["Videoassistierte Thorakoskopie unter Erhalt der Spontanatmung \u2013 eine an\u00e4sthesiologische Perspektive"],"prefix":"10.1055","volume":"146","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1746-7024","authenticated-orcid":false,"given":"Christoph","family":"Sponholz","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr An\u00e4sthesiologie und Intensivmedizin, Universit\u00e4tsklinikum Jena, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Winkens","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr An\u00e4sthesiologie und Intensivmedizin, Universit\u00e4tsklinikum Jena, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frank","family":"Fuchs","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr An\u00e4sthesiologie und Intensivmedizin, Universit\u00e4tsklinikum Jena, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexandros","family":"Moschovas","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Herz- und Thoraxchirurgie, Universit\u00e4tsklinikum Jena, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthias","family":"Steinert","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Herz- und Thoraxchirurgie, Universit\u00e4tsklinikum Jena, 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