Nonintubated Subxiphoid Bilateral Redo Lung Volume Reduction Surgery.

This report describes a nonintubated, bilateral thoracoscopic redo lung volume reduction surgery procedure through a single subxiphoid access in a patient who previously underwent one-stage bilateral volume reduction for upper lobe-predominant heterogeneous emphysema 19 years earlier. The patient was uneventfully discharged on postoperative day 2, and meaningful improvement in respiratory function and exercise tolerance occurred at 3 months postoperatively. This novel surgical approach may merge the potential benefits of a subxiphoid incision for bilateral treatment, non-intercostal passage of chest drains, and adoption of a nonintubated anesthesia protocol. (C) 2018 by The Society of Thoracic Surgeons.