Impact of Non-Intubated Spontaneous Breathing Versus Intubated General Anesthesia in Thoracoscopic Surgery on Postoperative Venous Thromboembolism

Background : This study aims to investigate the potential protective effect of non-intubated anesthesia against postoperative venous thromboembolism (VTE) in patients undergoing thoracoscopic lung surgery. By conducting a systematic comparative analysis with conventional general anesthesia using endotracheal intubation, we seek to evaluate the clinical value and safety profile of different anesthetic strategies with respect to postoperative VTE prevention. Methods : This retrospective study enrolled patients with lung cancer who underwent thoracoscopic pulmonary surgery at the Department of Cardiothoracic Surgery, Jinhua Central Hospital, between March 2025 and July 2025. Based on the anesthesia technique received, patients were divided into two groups: the non-intubated group (n = 25) and the endotracheal intubation group (n = 30). Demographic characteristics, preoperative and postoperative coagulation parameters, Caprini scores, operative time, postoperative recovery parameters, and the incidence of VTE were collected and compared between the two groups.Statistical analysis was performed using SPSS software (version 26.0). Continuous variables are presented as mean ± standard deviation or median with interquartile range, and comparisons between groups were conducted using the t-test or rank-sum test, as appropriate. Categorical variables were analyzed using the chi-square test. A P-value < 0.05 was considered statistically significant. Results : No significant differences were observed between the two groups in terms of age, sex distribution, body mass index (BMI), comorbidities, preoperative Caprini score, or preoperative white blood cell count (P > 0.05). Compared to the endotracheal intubation group, patients in the non-intubated group demonstrated earlier time to first ambulation and first postoperative bowel movement, more stable postoperative coagulation parameters, and a lower incidence of VTE. Conclusions : The application of non-intubated anesthesia in thoracoscopic lung surgery, compared to conventional general anesthesia with endotracheal intubation,effectively reduce the risk of venous thromboembolism by improving postoperative coagulation status and facilitating early ambulation, while simultaneously promoting enhanced postoperative recovery. These findings support the broader clinical adoption of this anesthetic approach.