Single-lumen tracheal ventilation for minimally invasive esophagectomy in patients with esophageal cancer.

OBJECTIVE

The aim of this study was to observe the efficacy and safety of single-lumen tracheal ventilation for esophageal cancer surgery.

METHODS

Thirty-eight patients with esophageal carcinoma who prepared for minimally invasive esophagectomy were included in this study. All of the included 38 patients were received single-lumen tracheal ventilation. The arterial blood gas index was monitored through the operation procedure and recorded at four-time points: before induction (T0), at the end of chest operation (T1), at the end of the abdominal operation (T2), and 30 min after extubation (T3). The heart rate (HR) and blood pressure (BP) were also monitored and recorded during the period of PetCO2 >50 mmHg. The agitation incidence rate was also recorded in awakening period.

RESULTS

All the included 38 patients were successfully completed the operation without conversing to open thoracotomy or open laparotomy. The artificial pneumothorax time, artificial pneumoperitoneum time, and operation time were 136.6 ± 26.2 min, 104.4 ± 21.3 min, and 306.7 ± 42.0 min, respectively. The patients' BP and HR was slight elevated but within the normal range (HR <100 breaths/min and BP <140/90 mmHg) when the PetCO2 >50 mmHg. Arterial blood gas results showed that PaCO2 significantly increased in time point of T1, T2, and T3 compared to T0 (P < 0.05); PaO2 significantly increased in time point of T1 and T2 compared to T0 (P < 0.05); HR significantly increased during the operation procedure of the time points T1 (P < 0.05). Of the included 38 patients, 8 were observed preoperative blood gas PaO2 <80 mmHg and the patients had decreased PaO2 in the time point T3 compared to other 30 normal preoperative PaO2 patients. Electrocardiogram monitoring showed that all patients do not appear arrhythmia and myocardial ischemia in the process of surgery. Two of 38 patients were found of mild agitated during waking period.

CONCLUSION

Single-lumen tracheal ventilation for esophageal cancer surgery is safe and can provide acceptable anesthesia effect.