|Table of Contents|

Comparison of application of pneumothorax under different carbon dioxide pressure in thoracoscopic surgery for early esophageal carcinoma

Journal Of Modern Oncology[ISSN:1672-4992/CN:61-1415/R]

Issue:
2019 01
Page:
60-64
Research Field:
Publishing date:

Info

Title:
Comparison of application of pneumothorax under different carbon dioxide pressure in thoracoscopic surgery for early esophageal carcinoma
Author(s):
Niu Wei1; Kong Shuang2; Meng Hongwei1
1.Department of Anesthesia,Anyang Tumor Hospital,Henan Anyang 455000，China；2.Department of Obstetrics and Gynecology,Anyang Maternal and Child Health Care Hospital，Henan Anyang 455000，China.
Keywords:
thoracoscopes; pneumothorax; artificial; carbon dioxide; early esophageal neoplasms; hemodynamics
PACS:
R735.1
DOI:
10.3969/j.issn.1672-4992.2019.01.015
Abstract:
Objective：To observe the effect of anesthesia and the changes in hemodynamics in the application of pneumothorax in thoracoscopic surgery for esophageal carcinoma under different carbon dioxide pressure.Methods：Under general anesthesia，sixty patients(ASAⅠ-Ⅱ，NYHAⅠ-Ⅱ，including 33 males and 27 females，aged 60±8 years old) undergone thoracoscopic radical resection of esophageal carcinoma by the same senior surgeon in the treatment group who screened out patients diagnosed as early esophageal cancer，were randomly divided into group A，B and C，with each group 20 cases and respectively 4，6，and 8 mmHg pneumothorax pressure applying pneumothorax by filling carbon dioxide by pleural side.Data of BP，HR，SPO2，VT，airway pressure(PaW) and PETCO2 of the three groups at following points of time were observed：During one-lung ventilation(T0)，the pressure of CO2 injected into one side of the thoracic cavity reached the standard for 1 min(T1)，5 min(T2)，30 min(T3)，60 min(T4)，90 min(T5)，120 min(T6) and double-lung ventilation for 5 min(T7).Adverse events rate were also observed.Results：SBP，DBP，SPO２ and VT at T1，T2 decreased significantly than those at T0 for all groups (P<0.05).For group B，there were no significant differences in blood pressure and heart rate at any time compared to those of group A(P>0.05).For group C，SBP，DBP at T3 and SPO２,VT at T2 decreased significantly than those at T0(P<0.05),HR increased significantly at T1-T6 comparing to T0(P<0.05),PaW and PETCO2 at T2-T6 increased comparing to that at T0(P<0.05).For group B，the indices of breath didn't change significantly at any time compared to those of group A(P>0.05).For group C，HR was higher at T3-T6 than that in group A(P<0.05),SBP and DBP at T3-T5 were lower than those of group A(P<0.05),PaW and PETCO2 were higher at T2-T5 than those of group A(P<0.05).Conclusion：It was more rational and feasible to inject carbon dioxide under the pressure of 6 mmHg into the chest cavity for thoracoscopic radical resection for esophageal carcinoma，but it requires high-level management of respiratory and circulatory during anesthesia.

References:

[1]Sun XX，Xu MQ.The current status and prospects on minimally invasive surgery for esophageal cancer［J］.Anhui Medicine and Pharmaceutical Journal，2013，17(07)：1238-1240.［孙翔翔，徐美青.食管癌微创手术的现状与展望［J］.安徽医药，2013，17(07)：1238-1240.］
[2]Zhang BY，Geng Q.Thoracoscopic laparoscopic esophagectomy and enhanced recovery after surgery［J］.World Chinese Journal of Digestology，2016，24(33)：4423-4429.［张博友，耿庆.全胸腹腔镜食管癌根治术与加速康复食管外科［J］.世界华人消化杂 志，2016，24(33)：4423-4429.］
[3]Ling JH.Clinical efficacy of thoracoscopy and thoracic surgery for early esophageal cancer［J］.Sichuan Medical Journal，2014，35(05)：569-571.［凌建华.胸腔镜与开胸手术治疗早期食管癌的临床疗效观察［J］.四川医学，2014，35(05)：569-571.］
[4]Tapias LF，Mathisen DJ，Wright CD，et al.Outcomes with open and minimally invasive ivor lewis esophagectomy after neoadjuvant therapy［J］.Ann Thorac Surg，2016，101：1097-1103.
[5]Palazzo F，Rosato EL，Chaudhary A，et al.Minimally invasive esophagectomy provides significant survival advantage compared with open or hybrid esophagectomy for patients with cancers of the esophagus and gas troesophageal junction［J］.Am Coll Surg，2015，220：672-679.
[6]Anderegg MC，Gisbertz SS，Van Berge Henegouwen MI.Minimally invasive surgery for oesophageal cancer［J］.Best Pract Res Clin Gastroenterol，2014，28：41-52.
[7]Levy RM，Pennathur A，Luketich JD.Randomized trial comparing minimally invasive esophagectomy and open esophagectomy：Early perioperative outcomes appear improved with a minimally invasive approach［J］.Semin Thorac Cardiovasc Surg，2012，24：153-154.
[8]Yin Z，Qi J.Clinical differences between artificial pneumothorax and double lumen intubation in thoracoscopic esophagectomy［J］.Journal of Regional Anatomy and Operative Surgery，2016，25(02)：125-127.［尹哲，綦俊.胸腔镜食管癌根治术中人工气胸与双腔插管临床应用对比分析［J］.局解手术学杂志，2016，25(02)：125-127.］
[9]Xing BC，Xu XM，Ji JJ，et al.Prevent and development of hypoxemia during one-lung ventilation［J］.Progress in Modern Biomedicine，2014，14(28)：5591-5594.［邢柏春，徐学敏，冀晋杰，等.单肺通气时低氧血症的预防的研究进展［J］.现代生物医学进展，2014，14(28)：5591-5594.］
[10]Jin ZS，Wang GY，Chen L.The causes of prevention and treatment of hypoxemia during one lung ventilation for thoracoscopic cardiac surgery［J］.Molecular Cardiology of China，2016，16(02)：1679-1681.［靳紫彬，王古岩，陈雷.胸腔镜心脏手术单肺通气时低氧血症的原因及防治［J］.中国分子心脏病学杂志，2016，16(02)：1679-1681.］
[11]Zhou Rongsheng，Liu Qining，Guan Zheng，et al.Clinical observation of low tidal volume with low positive end-expiratory pressure in one-lung ventilation patients undergoing esophageal cancer resection［J］.Modern Oncology，2012，20(02)：393-395.［周荣胜，刘齐宁，关正，等.低潮气量联合低呼气末正压通气用于食管癌根治术患者单肺通气的临床观察［J］.现代肿瘤医学，2012，20(02)：393-395.］
[12]Cai YW，Deng XL，Tang L，et al.Feasibility and safety of single-lumen endotracheal intubation and continuous carbon dioxide insufflation in thoracoscopic and laparoscopic esophagectomy for esophageal cancer［J］.Clinical Journal of Medical Officer，2013，41(01)：58-61.［蔡英蔚，邓信林，唐瑮，等.单腔气管插管二氧化碳人工气胸法应用于胸腹腔镜食管癌根治术的安全性研究［J］.临床军医杂志，2013，41(01)：58-61.］
[13]Xu YL，Li RH，Li L，et al.Application of lung protective ventilation strategy combined with repeated pulmonary recruitment in resection of esophageal carcinoma［J］.Shandong Medical Journal，2016，56(38)：47-49.［徐悦利，李汝泓，李玲，等.肺保护性通气策略联合反复肺复张在食管癌切除术中的应用［J］.山东医药，2016，56(38)：47-49.］
[14]Lv GC，Wang KZ，Awangdanzeng，et al.Comparison of postoperative arrhythmia between thoracoscopic and conventional thoracotomy in patients over the age years of 70 undergoing radical resection of pulmonary carcinoma［J］.Chinese Journal of Gerontology，2014，34(02)：486-488.［吕广超，王凯忠，阿旺丹增，等.70岁以上肺癌患者胸腔镜与传统开胸术后心律失常发生的比较［J］.中国老年学杂志，2014，34(02)：486-488.］

Memo

Memo:
-
Last Update: 2018-11-30