title: Benefits of awake uniportal pulmonary resection in a patient with a previous contralateral lobectomy.
abstract: Surgical resection of a contralateral recurrence of non-small cell lung cancer (NSCLC) is indicated in patients without evidence of disseminated disease and considered functionally operable. General anesthesia and double-lumen intubation involves one lobe ventilation in a patient treated with a previous lobectomy, thus increasing the risks of ventilator-induced injuries and the morbidity. Awake procedures facilitate the surgery decreasing the anesthetic and surgical times, keeping the diaphragm motion and diminishing the ventilator-induced injuries into the remaining contralateral lobe. We present a 43-year-old woman with a previous left-lower lobectomy for a 3.1-cm mucinous adenocarcinoma 15 months before without nodal involvement, who presents a right-lower lobe 8-mm cavitated nodule, with evident radiological growth and fine-needle aspiration concordant with mucinous adenocarcinoma. We suggest an awake procedure with locoregional epidural anesthesia.
authors.affiliation: 1 Thoracic Surgery Service, 2 Anesthesia Service, University General Hospital of Alicante, Spain.
authors.forename: Carlos
authors.initials: C
authors.lastname: Galvez
authors.affiliation: 1 Thoracic Surgery Service, 2 Anesthesia Service, University General Hospital of Alicante, Spain.
authors.forename: Jose
authors.initials: J
authors.lastname: Navarro-Martinez
authors.affiliation: 1 Thoracic Surgery Service, 2 Anesthesia Service, University General Hospital of Alicante, Spain.
authors.forename: Sergio
authors.initials: S
authors.lastname: Bolufer
authors.affiliation: 1 Thoracic Surgery Service, 2 Anesthesia Service, University General Hospital of Alicante, Spain.
authors.forename: Francisco
authors.initials: F
authors.lastname: Lirio
authors.affiliation: 1 Thoracic Surgery Service, 2 Anesthesia Service, University General Hospital of Alicante, Spain.
authors.forename: Juan Jose
authors.initials: JJ
authors.lastname: Mafe
authors.affiliation: 1 Thoracic Surgery Service, 2 Anesthesia Service, University General Hospital of Alicante, Spain.
authors.forename: Maria Jesus
authors.initials: MJ
authors.lastname: Rivera
authors.affiliation: 1 Thoracic Surgery Service, 2 Anesthesia Service, University General Hospital of Alicante, Spain.
authors.forename: Joaquin
authors.initials: J
authors.lastname: Roca
authors.affiliation: 1 Thoracic Surgery Service, 2 Anesthesia Service, University General Hospital of Alicante, Spain.
authors.forename: Benno
authors.initials: B
authors.lastname: Baschwitz
keywords: Thoracoscopy/VATS; anesthesia; lung cancer surgery