Zhang Fan, Zhou Zhijian, Liu Yingbei, Wang Xuan
Department of Anesthesiology, Children's Hospital of Fudan University, Shanghai, China.
Department of Cardiothoracic Surgery, Children's Hospital of Fudan University, Shanghai, China.
Front Surg. 2024 Nov 19;11:1446586. doi: 10.3389/fsurg.2024.1446586. eCollection 2024.
Thoracoscopic repair is a common surgical procedure to treat esophageal atresia (EA). During thoracoscopic surgery, the single-lung ventilation (SLV) technique is used to collapse one of the lungs to obtain a better surgical view. However, SLV is associated with risks in neonates. This study aimed to assess the perioperative benefits and risks of SLV in neonates who underwent thoracoscopic EA repair.
This single-center retrospective cohort study included all neonates who underwent thoracoscopic repair of EA at the Children's Hospital of Fudan University between January 1, 2016 and December 31, 2021. Neonates were assigned to SLV (Group S) or dual-lung ventilation (DLV, Group D) groups depending on the technique used intraoperatively. The intraoperative and postoperative information of the two groups were compared.
A total of 70 neonates were included in this study. Twenty-nine neonates were assigned to Group S and forty-one to Group D. No intraoperative adverse events were observed in either group. The surgery time of Group S was significantly shorter than that of Group D (81 ± 23 and 99 ± 29 min, respectively, = 0.004). In contrast, the anesthetic preparation time of Group S was significantly longer than that of Group D (54 ± 22 and 44 ± 16 min, respectively, = 0.030). The frequency of postoperative adverse events in Group S was similar to that of Group D (31.03% and 40.54%, respectively, = 0.453).
SLV was associated with a reduced surgery time for thoracoscopic repair of EA and longer anesthetic preparation time compared to DLV. The SLV was as safe as the DLV with potential advantages in thoracoscopic EA repair.
胸腔镜修复术是治疗食管闭锁（EA）的常见外科手术。在胸腔镜手术中，单肺通气（SLV）技术用于使一侧肺萎陷以获得更好的手术视野。然而，SLV在新生儿中存在风险。本研究旨在评估接受胸腔镜EA修复术的新生儿围手术期SLV的益处和风险。
这项单中心回顾性队列研究纳入了2016年1月1日至2021年12月31日期间在复旦大学附属儿科医院接受胸腔镜EA修复术的所有新生儿。根据术中使用的技术，将新生儿分为SLV组（S组）或双肺通气（DLV，D组）。比较两组的术中及术后信息。
本研究共纳入70例新生儿。29例新生儿被分配到S组，41例被分配到D组。两组均未观察到术中不良事件。S组的手术时间明显短于D组（分别为81±23分钟和99±29分钟，P = 0.004）。相比之下，S组的麻醉准备时间明显长于D组（分别为54±22分钟和44±16分钟，P = 0.030）。S组术后不良事件的发生率与D组相似（分别为31.03%和40.54%，P = 0.453）。
与DLV相比，SLV可缩短胸腔镜EA修复术的手术时间，但麻醉准备时间更长。在胸腔镜EA修复术中，SLV与DLV一样安全，且具有潜在优势。
