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Ann Transl Med. 2014 Sep;2(9):93. doi: 10.3978/j.issn.2305-5839.2014.05.07.

Benefits of awake uniportal pulmonary resection in a patient with a previous contralateral lobectomy.

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1 Thoracic Surgery Service, 2 Anesthesia Service, University General Hospital of Alicante, Spain.


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.


Thoracoscopy/VATS; anesthesia; lung cancer surgery

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