For a study, researchers determined spontaneous ventilation video-assisted thoracic surgery (SV-VATS) was equally effective as mechanical ventilation VATS in postoperative recovery (MV-VATS). However, the SV-VATS blebectomy’s perioperative safety was not fully proven. Researchers conducted a randomized controlled trial (NCT03016858) for primary spontaneous pneumothorax patients aged 16 to 50 years who underwent the SV-VATS and MV-VATS procedures. From April 2017 to January 2019, the trial was held in ten locations. The immediate result was to compare intraoperative and postoperative complications in SV-VATS and MV-VATS procedures. Secondary outcomes were total analgesia dose, change in vital signs during operation, procedural duration, recovery time, postoperative visual analog pain scores, and hospitalization length. 

There were 335 patients in this study. In terms of intraoperative and postoperative complication rates, there was no significant difference between the SV-VATS and the MV-VATS groups (17.90% vs. 22.09%; relative risk, 0.81; 95% CI, 0.52-1.26; P=.346). Sufentanil (11.37 μg vs. 20.92 μg; P<.001) and remifentanil (269.78 μg vs. 404.96 μg; P<.001) were linked with considerably lower total doses of intraoperative opioid drugs in the SV-VATS group. Extubation time (12.28 minutes vs. 17.30 minutes; P=.002), postanesthesia care unit recovery time (25.43 minutes vs. 30.67 minutes; P=.02), and food intake time (346.07 minutes vs. 404.02 minutes; P=.002) were also shorter with the SV-VATS treatment. Furthermore, the SV-VATS technique reduced anesthetic costs ($297.81 vs. $399.81; P<.001) compared to the MV-VATS operation. SV-VATS was non-inferior to MV-VATS in terms of complication rate in patients undergoing lobectomy for primary spontaneous pneumothorax.