{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T23:07:44Z","timestamp":1784934464453,"version":"3.55.0"},"reference-count":30,"publisher":"SAGE Publications","issue":"7","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Int Med Res"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Postoperative pulmonary complications are a leading determinant of perioperative mortality and adverse prognosis in thoracic surgery. This study aimed to explore the association between nonintubated video-assisted thoracoscopic surgery versus intubated video-assisted thoracoscopic surgery and the incidence of postoperative pulmonary complications as well as perioperative anesthesia-related adverse events in patients undergoing video-assisted thoracoscopic surgery lung resection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A single-center retrospective cohort study was conducted in consecutive patients undergoing elective video-assisted thoracoscopic surgery lung resection (January 2023 to September 2025, Chongqing General Hospital). The primary outcome was the incidence of postoperative pulmonary complications (Melbourne Group Scale), and the secondary outcomes included recovery and adverse events. Multivariate logistic regression using the enter method was performed to identify independent factors associated with postoperative pulmonary complications, and inverse probability of treatment weighting was used to balance baseline covariates between the groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 486 patients were included (290 intubated video-assisted thoracoscopic surgery and 196 nonintubated video-assisted thoracoscopic surgery). The nonintubated video-assisted thoracoscopic surgery group had a lower overall in-hospital incidence of postoperative pulmonary complications (4.59% vs. 23.45%; unadjusted odds ratio = 0.157, 95% confidence interval: 0.078\u20130.318; adjusted odds ratio = 0.243, 95% confidence interval: 0.107\u20130.550; inverse probability of treatment weighting-adjusted odds ratio = 0.215, 95% confidence interval: 0.092\u20130.503; all p\u2009&lt;\u20090.001). The nonintubated video-assisted thoracoscopic surgery group had a higher incidence of intraoperative hypercapnia (59.69% vs. 4.83%) but lower incidences of postoperative hypoxemia (2.04% vs. 12.07%) and postoperative nausea and vomiting (PONV) (2.04% vs. 10.34%; all p\u2009&lt;\u20090.001) along with a shorter recovery time and lower sufentanil consumption and chest drainage volume (all p\u2009&lt;\u20090.001). The conversion rate from nonintubated video-assisted thoracoscopic surgery to intubated video-assisted thoracoscopic surgery was 2.04% (4\/196), with no neurological or cardiovascular adverse events related to intraoperative hypercapnia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this retrospective cohort study, nonintubated video-assisted thoracoscopic surgery was associated with fewer postoperative pulmonary complications, faster recovery, and lower opioid use, providing clinical evidence for anesthesia optimization. However, large-scale prospective trials are needed to establish causal relationships.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/03000605261469830","type":"journal-article","created":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T06:18:35Z","timestamp":1784614715000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of nonintubated versus intubated anesthesia on postoperative pulmonary complications after video-assisted thoracoscopic lung resection: A retrospective cohort study"],"prefix":"10.1177","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0435-1492","authenticated-orcid":false,"given":"Rui","family":"Xu","sequence":"first","affiliation":[{"name":"Chongqing General Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Yang","sequence":"additional","affiliation":[{"name":"Chongqing General Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peng","family":"Kong","sequence":"additional","affiliation":[{"name":"Chongqing General Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Yang","sequence":"additional","affiliation":[{"name":"Chongqing General Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Zhu","sequence":"additional","affiliation":[{"name":"Chongqing General Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yun","family":"Xue","sequence":"additional","affiliation":[{"name":"Chongqing General Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fuxia","family":"Wang","sequence":"additional","affiliation":[{"name":"Chongqing General Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3935-6819","authenticated-orcid":false,"given":"Zhou","family":"Zhang","sequence":"additional","affiliation":[{"name":"Chongqing General Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,7,20]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-2600(23)00346-6"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1111\/aas.13388"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13019-018-0717-6"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.21037\/jtd.2018.10.36"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2016.4065"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000005115"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000003719"},{"key":"e_1_3_3_9_2","first-page":"333","article-title":"Risk factors for postoperative pulmonary complications and prolonged hospital stay in pulmonary resection patients: a retrospective study","volume":"71","author":"Bevilacqua Filho CT","year":"2021","unstructured":"Bevilacqua Filho CT, Schmidt AP, Felix EA, et al. Risk factors for postoperative pulmonary complications and prolonged hospital stay in pulmonary resection patients: a retrospective study. Braz J Anesthesiol 2021; 71: 333\u2013338.","journal-title":"Braz J Anesthesiol"},{"key":"e_1_3_3_10_2","article-title":"Postoperative pulmonary complications and perioperative strategies: a systematic review","volume":"15","author":"Lusquinhos J","year":"2023","unstructured":"Lusquinhos J, Tavares M, Abelha F. Postoperative pulmonary complications and perioperative strategies: a systematic review. Cureus 2023; 15: e38786.","journal-title":"Cureus"},{"key":"e_1_3_3_11_2","article-title":"Postoperative esketamine improves ventilation after video-assisted thoracoscopic lung resection: a double-blinded randomized controlled trial","volume":"10","author":"Fu M","year":"2024","unstructured":"Fu M, Xu R, Chen G, et al. Postoperative esketamine improves ventilation after video-assisted thoracoscopic lung resection: a double-blinded randomized controlled trial. Heliyon 2024; 10: e25100.","journal-title":"Heliyon"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12890-020-1073-6"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13741-024-00437-0"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.jvca.2015.10.004"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000000808"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1097\/ACO.0000000000000945"},{"key":"e_1_3_3_17_2","first-page":"10875","article-title":"Thoracic paravertebral nerve block combined laryngeal mask airway with preservation of spontaneous breathing can accelerate postoperative recovery","volume":"27","author":"Zheng YF","year":"2023","unstructured":"Zheng YF, Jiang YS, Liu HT, et al. Thoracic paravertebral nerve block combined laryngeal mask airway with preservation of spontaneous breathing can accelerate postoperative recovery. Eur Rev Med Pharmacol Sci 2023; 27: 10875\u201310883.","journal-title":"Eur Rev Med Pharmacol Sci"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1097\/imi.0000000000000075"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1111\/ajco.13726"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12957-021-02181-x"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12871-022-01667-9"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.3389\/fsurg.2026.1834893"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.3390\/jcm14196731"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000001395"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-147-8-200710160-00010"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.21037\/tlcr-21-663"},{"key":"e_1_3_3_27_2","first-page":"99","article-title":"Non-intubated thoracic surgery: nostalgic or reasonable?","volume":"3","author":"Pompeo E","year":"2015","unstructured":"Pompeo E. Non-intubated thoracic surgery: nostalgic or reasonable? Ann Transl Med 2015; 3: 99.","journal-title":"Ann Transl Med"},{"key":"e_1_3_3_28_2","volume-title":"Ventilator-induced lung injury (VILI)","author":"Ajith Kumar AK","unstructured":"Ajith Kumar AK, Anjum F. Ventilator-induced lung injury (VILI). In: StatPearls. Treasure Island: StatPearls Publishing, 2023."},{"key":"e_1_3_3_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.asjsur.2017.01.005"},{"key":"e_1_3_3_30_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2012.10.082"},{"key":"e_1_3_3_31_2","article-title":"Effect of acute hypercapnia on outcomes and predictive risk factors for complications among patients receiving bronchoscopic interventions under general anesthesia","volume":"10","author":"Cheng Q","year":"2015","unstructured":"Cheng Q, Zhang J, Wang H, et al. Effect of acute hypercapnia on outcomes and predictive risk factors for complications among patients receiving bronchoscopic interventions under general anesthesia. PLOS One 2015; 10: e0130771.","journal-title":"PLOS One"}],"container-title":["Journal of International Medical Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/03000605261469830","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/03000605261469830","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/03000605261469830","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T22:47:59Z","timestamp":1784933279000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/03000605261469830"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7]]},"references-count":30,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1177\/03000605261469830"],"URL":"https:\/\/doi.org\/10.1177\/03000605261469830","relation":{},"ISSN":["0300-0605","1473-2300"],"issn-type":[{"value":"0300-0605","type":"print"},{"value":"1473-2300","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7]]},"article-number":"03000605261469830"}}