title: Better perioperative outcomes in thoracoscopic-esophagectomy with two-lung ventilation in semi-prone position.
abstract: BACKGROUND
  One-lung ventilation (OLV) anesthesia intubation route is often used in patients undergoing thoracoscopic-esophagectomy in semi-prone position. Recently, the two-lung ventilation (TLV) approach becomes popular. However, limited studies have compared the two ventilation approaches in parallel. Here, we report a single-center, retrospective study of comparing TLV and OLV approach in patients undergoing thoracoscopic-esophagectomy in semi-prone position.
  
  
  METHODS
  From January 2013 to November 2014, 147 patients were enrolled into the current study and were given thoracoscopic-esophagectomy in semi-prone position either by OLV or TLV. Intraoperative respiratory functional data and perioperative surgical parameters of the two approaches were collected and analyzed.
  
  
  RESULTS
  Of the 147 patients, 64 patients received OLV and 83 patients received TLV, and all of them were successfully under gone thoracoscopic procedures without conversion to open thoracotomy. There was no incidence of major intraoperative complications or perioperative death. There were no statistically different in postoperative respiratory complications, either. However, TLV approach resulted in better intraoperative respiratory function (PaCO2, PaO2, SaO2), shorter preparation time for anesthesia induction, less blood loss, shorter thoracoscopic operating time and less postoperative hospital stay (P<0.05). The incidence of postoperative respiratory complications and quantity of the resected thoracic lymph node showed no difference between the two ventilation approach (P>0.05).
  
  
  CONCLUSIONS
  This study demonstrated that TLV intubation approach is superior to OLV approach during the thoracoscopic-esophagectomy in semi-prone position. According to this, TLV approach is a technically feasible, convenient and safe anesthesia induction approach for esophageal cancer surgery.
authors.affiliation: Division of Digestive Surgery, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an 710032, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Cai
authors.affiliation: Department of Anesthesiology, Northwest Women's and Children's Hospital, Xi'an 710061, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Li
authors.affiliation: Division of Digestive Surgery, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an 710032, China.
authors.forename: Li
authors.initials: L
authors.lastname: Sun
authors.affiliation: Division of Digestive Surgery, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an 710032, China.
authors.forename: Xue-Wen
authors.initials: XW
authors.lastname: Yang
authors.affiliation: Division of Digestive Surgery, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an 710032, China.
authors.forename: Wen-Bin
authors.initials: WB
authors.lastname: Wang
authors.affiliation: Division of Digestive Surgery, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an 710032, China.
authors.forename: Fan
authors.initials: F
authors.lastname: Feng
authors.affiliation: Division of Digestive Surgery, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an 710032, China.
authors.forename: Guang-Hui
authors.initials: GH
authors.lastname: Xu
authors.affiliation: Division of Digestive Surgery, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an 710032, China.
authors.forename: Man
authors.initials: M
authors.lastname: Guo
authors.affiliation: Division of Digestive Surgery, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an 710032, China.
authors.forename: Xiao
authors.initials: X
authors.lastname: Lian
authors.affiliation: Division of Digestive Surgery, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an 710032, China.
authors.forename: Hong-Wei
authors.initials: HW
authors.lastname: Zhang
keywords: Esophageal cancer; one-lung ventilation (OLV); perioperative period; semi-prone position; thoracoscopic-esophagectomy; two-lung ventilation (TLV)