{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T19:44:24Z","timestamp":1787773464987,"version":"build-2784847793"},"reference-count":42,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,7,7]],"date-time":"2025-07-07T00:00:00Z","timestamp":1751846400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Segmentectomy under non-intubated anesthesia (NIA) has demonstrated comparable conventional clinical outcomes to segmentectomy performed under intubated general anesthesia (IGA). However, differences in early patient-reported outcomes (PROs) between the two anesthetic approaches remain unclear. This study aimed to evaluate symptom burden and functional status from the patient\u2019s perspective under different anesthesia modalities.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients who underwent segmentectomy via either IGA or NIA were included. Perioperative symptom severity and functional status were assessed using the PSA-lung scale. PROs data were collected at various perioperative time points, and comparisons between groups were analyzed using a linear mixed-effects model.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among the 380 enrolled patients, 160 underwent segmentectomy under NIA, and 220 under IGA. After propensity score matching (PSM), baseline characteristics were comparable between groups. On postoperative day 7, patients in the NIA group reported significantly milder symptoms of pain (P&amp;lt;0.001), cough (P&amp;lt;0.001), dyspnea (P=0.011), and drowsiness (P&amp;lt;0.001) compared to those in the IGA group. Additionally, the NIA group experienced less functional interference in walking (P&amp;lt;0.001) and general function (P&amp;lt;0.001). Within one month postoperatively, patients in the IGA group reported more severe cough (P&amp;lt;0.001) and anxiety (P&amp;lt;0.001) than those in the NIA group. There were no significant differences in short-term clinical outcomes between the two groups, although the NIA group had a longer operative time (P&amp;lt;0.001) but a shorter postoperative hospital stay (P&amp;lt;0.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>PROs are essential indicators of postoperative recovery after segmentectomy. Compared to intubated anesthesia, non-intubated anesthesia is associated with fewer severe early symptoms, lower functional burden, and shorter hospitalization following segmentectomy.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fonc.2025.1602812","type":"journal-article","created":{"date-parts":[[2025,7,7]],"date-time":"2025-07-07T05:27:43Z","timestamp":1751866063000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Early postoperative patient-reported outcomes in thoracoscopic segmentectomy: a comparative study of non-intubated anesthesia versus intubated general anesthesia"],"prefix":"10.3389","volume":"15","author":[{"given":"He","family":"Guan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinchao","family":"Bi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wantong","family":"Zheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yahao","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhijun","family":"Han","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Wei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiwei","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,7,7]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1038\/s41571-023-00798-3","article-title":"The global burden of lung cancer: current status and future trends","volume":"20","author":"Leiter","year":"2023","journal-title":"Nat Rev Clin Oncol"},{"key":"B2","doi-asserted-by":"publisher","first-page":"395","DOI":"10.1056\/NEJMoa1102873","article-title":"Reduced lung-cancer mortality with low-dose computed tomographic screening","volume":"365","author":"Aberle","year":"2011","journal-title":"N Engl J Med"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(21)02333-3","article-title":"Segmentectomy versus lobectomy in small-sized peripheral non-small-cell lung cancer (JCOG0802\/WJOG4607L): a multicentre, open-label, phase 3, randomised, controlled, non-inferiority trial","volume":"399","author":"Saji","year":"2022","journal-title":"Lancet"},{"key":"B4","doi-asserted-by":"publisher","first-page":"895","DOI":"10.1016\/j.jtcvs.2019.03.090","article-title":"Comparison of pulmonary segmentectomy and lobectomy: Safety results of a randomized trial","volume":"158","author":"Suzuki","year":"2019","journal-title":"J Thorac Cardiovasc Surg"},{"key":"B5","doi-asserted-by":"publisher","first-page":"149","DOI":"10.1186\/s13019-014-0149-x","article-title":"AVATS: Awake Video Assisted Thoracic Surgery\u2013extended series report","volume":"9","author":"Klijian","year":"2014","journal-title":"J Cardiothorac Surg"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.21037\/tlcr-2025-273IF:4.0Q1","article-title":"Multidisciplinary international expert consensus on perioperative airway management","volume":"14","author":"Wang","year":"2025","journal-title":"Transl Lung Cancer Res"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.21037\/jtd.2018.05.126","article-title":"Effect of different thoracic anesthesia on postoperative cough","volume":"10","author":"Chen","year":"2018","journal-title":"J Thorac Dis"},{"key":"B8","doi-asserted-by":"publisher","first-page":"101418","DOI":"10.1016\/j.accpm.2024.101418","article-title":"Combined hypoglossal and lingual nerve palsy: An unrecognized complication after orotracheal intubation for general anaesthesia. A case report of a day surgery patient and a literature review","volume":"43","author":"Cazenave","year":"2024","journal-title":"Anaesth Crit Care Pain Med"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2013.05.065","article-title":"Nonintubated thoracoscopic anatomical segmentectomy for lung tumors","volume":"96","author":"Hung","year":"2013","journal-title":"Ann Thorac Surg"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2019.01.013","article-title":"Nonintubated thoracoscopic surgery for lung tumor: seven years' Experience with 1,025 patients","volume":"107","author":"Hung","year":"2019","journal-title":"Ann Thorac Surg"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2012.10.082","article-title":"Feasibility and safety of nonintubated thoracoscopic lobectomy for geriatric lung cancer patients","volume":"95","author":"Wu","year":"2013","journal-title":"Ann Thorac Surg"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1016\/j.asjsur.2023.09.038","article-title":"Non-intubated versus intubated video-assisted thoracoscopic lobectomy for lung cancer patients","volume":"47","author":"Yu","year":"2024","journal-title":"Asian J Surg"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.3978\/j.issn.2072-1439.2012.08.07","article-title":"Nonintubated thoracoscopic lung resection: a 3-year experience with 285 cases in a single institution","volume":"4","author":"Chen","year":"2012","journal-title":"J Thorac Dis"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2012.01.062","article-title":"Nonintubated needlescopic video-assisted thoracic surgery for management of peripheral lung nodules","volume":"93","author":"Tseng","year":"2012","journal-title":"Ann Thorac Surg"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000005005","article-title":"A randomized controlled trial evaluating electronic outpatient symptom monitoring after ambulatory cancer surgery","volume":"274","author":"Pusic","year":"2021","journal-title":"Ann Surg"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdy488","article-title":"Pilot randomized trial of an electronic symptom monitoring intervention for hospitalized patients with cancer","volume":"30","author":"Nipp","year":"2019","journal-title":"Ann Oncol"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2017.7156","article-title":"Overall survival results of a trial assessing patient-reported outcomes for symptom monitoring during routine cancer treatment","volume":"318","author":"Basch","year":"2017","journal-title":"JAMA"},{"key":"B18","doi-asserted-by":"publisher","first-page":"79","DOI":"10.1186\/1477-7525-4-79","article-title":"Guidance for industry: Patient reported outcome measures: Use in medical product development to support labeling claims: Draft guidance","volume":"4","year":"2006","journal-title":"Health Qual Life Outcomes"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1097\/JTO.0b013e3181a0d82e","article-title":"The IASLC lung cancer staging project: a proposal for a new international lymph node map in the forthcoming seventh edition of the TNM classification for lung cancer","volume":"4","author":"Rusch","year":"2009","journal-title":"J Thorac Oncol"},{"key":"B20","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s11136-021-02976-1","article-title":"28th annual conference of the international society for quality of life research","volume":"30","year":"2021","journal-title":"Qual Life Res"},{"key":"B21","doi-asserted-by":"publisher","first-page":"956","DOI":"10.1016\/S0003-4975(00)02223-2","article-title":"Is segmentectomy with lymph node assessment an alternative to lobectomy for non-small cell lung cancer of 2 cm or smaller","volume":"71","author":"Okada","year":"2001","journal-title":"Ann Thorac Surg"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1097\/01.sla.0000133083.54934.ae","article-title":"Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey","volume":"240","author":"Dindo","year":"2004","journal-title":"Ann Surg"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2021.08.058","article-title":"Early patient-reported outcomes after uniportal vs multiportal thoracoscopic lobectomy","volume":"114","author":"Dai","year":"2022","journal-title":"Ann Thorac Surg"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-021-10946-7","article-title":"Early postoperative patient-reported outcomes after thoracoscopic segmentectomy versus lobectomy for small-sized peripheral non-small-cell lung cancer","volume":"29","author":"Dai","year":"2022","journal-title":"Ann Surg Oncol"},{"key":"B25","doi-asserted-by":"publisher","first-page":"215","DOI":"10.1186\/s13019-024-02635-9","article-title":"Comparison of early patient-reported outcomes between uniportal thoracoscopic segmentectomy and wedge resection for peripheral small-sized non-small-cell lung cancer","volume":"19","author":"Zhao","year":"2024","journal-title":"J Cardiothorac Surg"},{"key":"B26","doi-asserted-by":"publisher","first-page":"108481","DOI":"10.1016\/j.ejso.2024.108481","article-title":"Comparison of early postoperative patient-reported outcomes after multiportal robotic-assisted thoracoscopic surgery and uniportal video-assisted thoracoscopic surgery for non-small cell lung cancer","volume":"50","author":"Zhang","year":"2024","journal-title":"Eur J Surg Oncol"},{"key":"B27","doi-asserted-by":"publisher","first-page":"100846","DOI":"10.1016\/j.accpm.2021.100846","article-title":"Tailored anaesthesia for thoracoscopic surgery promoting enhanced recovery: The state of the art","volume":"40","author":"Elsayed","year":"2021","journal-title":"Anaesth Crit Care Pain Med"},{"key":"B28","doi-asserted-by":"publisher","first-page":"14163","DOI":"10.3389\/ti.2025.14163","article-title":"The path forward: A review on enhanced recovery after cardiothoracic transplantation","volume":"38","author":"Bello","year":"2025","journal-title":"Transpl Int"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.2147\/CMAR.S267322","article-title":"Comprehensive Pulmonary Rehabilitation is an Effective Way for Better Postoperative Outcomes in Surgical Lung Cancer Patients with Risk Factors: A Propensity Score-Matched Retrospective Cohort Study","volume":"12","author":"Zhou","year":"2020","journal-title":"Cancer Manag Res"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2020.08.2086","article-title":"Global physiology and pathophysiology of cough: part 1: cough phenomenology - CHEST guideline and expert panel report","volume":"159","author":"Lee","year":"2021","journal-title":"Chest"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.1378\/chest.130.6.1839","article-title":"Prevalence of depressive symptoms among patients with chronic cough","volume":"130","author":"Dicpinigaitis","year":"2006","journal-title":"Chest"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.5606\/tgkdc.dergisi.2019.18214","article-title":"Comparison of awake and intubated video-assisted thoracoscopic surgery in the diagnosis of pleural diseases: A prospective multicenter randomized trial","volume":"27","author":"Kocat\u00fcrk","year":"2019","journal-title":"Turk Gogus Kalp Damar Cerrahisi Derg"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.1111\/aas.13572","article-title":"Combined non-intubated anaesthesia and paravertebral nerve block in comparison with intubated anaesthesia in children undergoing video-assisted thoracic surgery","volume":"64","author":"Wei","year":"2020","journal-title":"Acta Anaesthesiol Scand"},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.3791\/65235","article-title":"Non-intubated video-assisted thoracoscopic surgery","volume":"195","author":"Bin","year":"2023","journal-title":"J Vis Exp"},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.3389\/fsurg.2021.801718","article-title":"Non-intubated thoracoscopic surgery-pros and cons","volume":"8","author":"Jan\u00edk","year":"2021","journal-title":"Front Surg"},{"key":"B36","doi-asserted-by":"publisher","DOI":"10.3389\/fphys.2022.953951","article-title":"Impact of intubated vs. non-intubated anesthesia on postoperative diaphragmatic function: Results from a prospective observational study","volume":"13","author":"Steinberg","year":"2022","journal-title":"Front Physiol"},{"key":"B37","doi-asserted-by":"publisher","DOI":"10.3389\/fsurg.2022.853643","article-title":"Non-intubated thoracic surgery: wedge resections for peripheral pulmonary nodules","volume":"9","author":"Ambrogi","year":"2022","journal-title":"Front Surg"},{"key":"B38","doi-asserted-by":"publisher","first-page":"379","DOI":"10.1186\/s12931-022-02250-z","article-title":"Thoracic surgery in the non-intubated spontaneously breathing patient","volume":"23","author":"Grott","year":"2022","journal-title":"Respir Res"},{"key":"B39","doi-asserted-by":"publisher","first-page":"87","DOI":"10.1186\/s12957-021-02181-x","article-title":"Comparison of non-intubated and intubated video-assisted thoracoscopic surgeries of major pulmonary resections for lung cancer-a meta-analysis","volume":"19","author":"Xue","year":"2021","journal-title":"World J Surg Oncol"},{"key":"B40","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp1611252","article-title":"Patient-reported outcomes - harnessing patients' Voices to improve clinical care","volume":"376","author":"Basch","year":"2017","journal-title":"N Engl J Med"},{"key":"B41","doi-asserted-by":"publisher","DOI":"10.21037\/tlcr-21-629","article-title":"Perioperative and long-term outcomes of spontaneous ventilation video-assisted thoracoscopic surgery for non-small cell lung cancer","volume":"10","author":"Zheng","year":"2021","journal-title":"Transl Lung Cancer Res"},{"key":"B42","doi-asserted-by":"publisher","DOI":"10.3389\/fsurg.2022.800082","article-title":"Spontaneous ventilation video-assisted thoracoscopic surgery for non-small-cell lung cancer patients with poor lung function: short- and long-term outcomes","volume":"9","author":"Wang","year":"2022","journal-title":"Front Surg"}],"container-title":["Frontiers in Oncology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2025.1602812\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,7]],"date-time":"2025-07-07T05:27:44Z","timestamp":1751866064000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2025.1602812\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,7]]},"references-count":42,"alternative-id":["10.3389\/fonc.2025.1602812"],"URL":"https:\/\/doi.org\/10.3389\/fonc.2025.1602812","relation":{},"ISSN":["2234-943X"],"issn-type":[{"value":"2234-943X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,7]]},"article-number":"1602812"}}