Single-port thoracoscopic surgery for pneumothorax under two-lung ventilation with carbon dioxide insufflation
- Authors
- Han, Kook Nam; Kim, Hyun Koo; Lee, Hyun Joo; Lee, Dong Kyu; Kim, Heezoo; Lim, Sang Ho; Choi, Young Ho
- Issue Date
- Jun-2016
- Publisher
- AME PUBLISHING COMPANY
- Keywords
- Pneumothorax; thoracoscopy/video-assisted thoracoscopic surgery (VATS); minimally invasive surgery; anesthesia; ventilation
- Citation
- JOURNAL OF THORACIC DISEASE, v.8, no.6, pp 1080 - 1086
- Pages
- 7
- Journal Title
- JOURNAL OF THORACIC DISEASE
- Volume
- 8
- Number
- 6
- Start Page
- 1080
- End Page
- 1086
- URI
- https://scholarworks.bwise.kr/cau/handle/2019.sw.cau/74559
- DOI
- 10.21037/jtd.2016.03.95
- ISSN
- 2072-1439
2077-6624
- Abstract
- Background: The development of single-port thoracoscopic surgery and two-lung ventilation reduced the invasiveness of minor thoracic surgery. This study aimed to evaluate the feasibility and safety of single-port thoracoscopic bleb resection for primary spontaneous pneumothorax using two-lung ventilation with carbon dioxide insufflation. Methods: Between February 2009 and May 2014, 130 patients underwent single-port thoracoscopic bleb resection under two-lung ventilation with carbon dioxide insufflation. Access was gained using a commercial multiple-access single port through a 2.5-cm incision; carbon dioxide gas was insufflated through a port channel. A 5-mm thoracoscope, articulating endoscopic devices, and flexible endoscopic staplers were introduced through a multiple-access single port for bulla resection. Results: The mean time from endotracheal intubation to incision was 29.2 +/- 7.8 minutes, the mean operative time was 30.9 +/- 8.2 minutes, and the mean total anesthetic time was 75.5 +/- 14.4 minutes. There were no anesthesia-related complications or wound problems. The chest drain was removed after a mean of 3.7 +/- 1.4 days and patients were discharged without complications 4.8 +/- 1.5 days from the operative day. During a mean 7.5 +/- 10.1 months of follow-up, there were five recurrences (3.8%) in operated thorax. Conclusions: The anesthetic strategy of single-lumen intubation with carbon dioxide gas insufflation can be a safe and feasible option for single-port thoracoscopic bulla resection as it represents the least invasive surgical option with the potential advantages of reducing operative time and one-lung ventilation-related complications without diminishing surgical outcomes.
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