[Tracheo-bronchial intubation for surgery of the esophagus via a thoracic approach].
Tracheo-bronchial intubation using a double-lumen Carlens tube provides the surgeon with a mediastinal operating field free of any obstruction by the lung and provides greater surgical ease than that of an assistant retracting a constantly invasive lung with tracheal intubation. This anaesthetic technique involving the ventilation of only one lung during the endothoracic period of the surgical procedure has not been used routinely for extra-pulmonary surgery since the shunt which is created leads to a fear of dangerous hypoxia. The aim of this study involving 30 patients is to demonstrate that the blood oxygen saturation obtained by the careful ventilation of a single lung, that of the side on which the patient is lying, is perfectly acceptable and comparable with the preoperative oxygen saturation of the subject at rest. This is obtained at the price of an increase in insufflation pressures of the order of 100 percent. Re-expansion of the collapsed lung without visual confirmation after careful endobronchial aspiration makes it possible to prevent the development of areas of micro-atelectasia and to ensure the absence of any pulmonary postoperative complications.
D000328:Adult; D000368:Aged; D000769:Anesthesia, Inhalation; D001980:Bronchi; D004935:Esophageal Diseases / Q000601:surgery*; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D000860:Hypoxia / Q000517:prevention & control; D007442:Intubation, Intratracheal / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000097:blood; D010102:Oxygen Inhalation Therapy / Q000379:methods; D011031:Pneumothorax, Artificial; D013909:Thorax
D010100:Oxygen
L'intubation trachéo-bronchique pour chirurgie de l'oesophage par voie thoracique.