One-lung or two-lung ventilation during transthoracic oesophagectomy?
The purpose of this study was to determine the safety of one-lung ventilation (OLV) during transthoracic oesophagectomy. Changes in circulatory and respiratory variables during and after operation were compared in patients receiving OLV or conventional two-lung ventilation (TLV). Thirty patients undergoing transthoracic oesophagectomy were randomly divided into either the OLV or the TLV group. During thoracotomy, FIO2 was kept to 1.0. The PaO2 in the OLV group decreased from the prethoracotomy value of 467 +/- 84 mmHg to 227 +/- 162 mmHg during OLV. This decrease was greater than the decrease from 484 +/- 79 mmHg to 380 +/- 119 mmHg in the TLV group (P < 0.05). The shunt ratio increased in the OLV group from 20 +/- 7% to 35 +/- 13% during OLV which was greater than the increase in the TLV group (26 +/- 7% from 17 +/- 8%) (P < 0.05). Other variables and the incidence of the complications, however, were little different between the two groups during and after OLV and up to POD 3. It is concluded that OLV is as safe as TLV during oesophagectomy.
Tachibana
M
M
Second Department of Surgery, Shimane Medical University, Izumo, Japan.
Abe
S
S
Tabara
H
H
Yoshimura
H
H
Matsuura
H
H
Nagasue
N
N
Nakamura
T
T
D000767:Anesthesia, Epidural; D000769:Anesthesia, Inhalation; D004938:Esophageal Neoplasms / Q000601:surgery; D016629:Esophagectomy / Q000009:adverse effects / Q000379:methods; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D007442:Intubation, Intratracheal / Q000295:instrumentation / Q000379:methods*; D008171:Lung Diseases / Q000000981:diagnostic imaging / Q000209:etiology; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000097:blood; D011446:Prospective Studies; D011859:Radiography; D012119:Respiration / Q000502:physiology; D012121:Respiration, Artificial / Q000295:instrumentation / Q000379:methods*; D013908:Thoracotomy / Q000009:adverse effects; D013990:Tidal Volume; D014692:Ventilation-Perfusion Ratio
D010100:Oxygen