无管化麻醉在胸科手术中的应用研究进展

电视胸腔镜手术（video-assisted thoracoscopic surgery，VATS）是目前治疗肺癌最常用的微创外科方式，但在提高患者舒适度和促进快速康复方面仍有待改进。一种新的无管化电视胸腔镜手术（tubeless VATS）正在逐渐发展，可以避免给患者使用气管插管、中心静脉导管、硬膜外导管、胸腔引流管和导尿管。Tubeless VATS结合当前最先进、创伤最小的麻醉、视频辅助外科和围术期护理方法，可确保手术的安全性和可行性，并且能够使患者在术后实现早期进食、下床和出院，使胸科日间手术成为可能。Tubeless VATS在肺癌手术乃至胸外科手术中的应用，见证了胸腔镜手术从微创到超微创的发展，使患者从快速康复外科治疗中最大获益。 

Research progress of tubeless anesthesia in thoracic surgery

Video-assisted thoracoscopic surgery (VATS) is the most used, minimally invasive surgical method in the treatment of lung cancer. Despite this, VATS still needs to be improved to better facilitate patient comfort and promote rapid recovery after surgery. A new tubeless VATS technique is being developed to avoid the practice of tracheal intubation and the use of central lines, epidural or chest tubes, and urinary catheters in patients requiring thoracoscopic surgery. The new tubeless VATS technique combines highly evolved and less invasive techniques used in anesthesia, video-assisted surgery, and perioperative care to ensure safe and feasible surgery, allowing patients to achieve early postoperative oral feeding, ambulation, and discharge. Tubeless VATS is thus excellent in enabling thoracic day surgery. The application of tubeless VATS in lung cancer and thoracic surgery has optimized minimally invasive thoracoscopic surgery technique. Additionally, tubeless VATS can maximize patient benefit from fast track surgery.