Akimoto Mariko, Satoh Daizoh, Kawagoe Izumi, Ooizumi-Goto Yuri, Mitaka Chieko, Hashimoto Takashi, Hayashida Masakazu
Juntendo Med J. 2025 Jun 4;71(3):180-186. doi: 10.14789/ejmj.JMJ24-0038-OA. eCollection 2025.
Minimally invasive thoracoscopic esophagectomy may result in superior post-operative outcomes compared to open esophagectomy. We compared arterial blood gas data during one-lung ventilation (OLV) between thoracoscopic esophagectomy and open esophagectomy.
37 patients undergoing thoracoscopic esophagectomy (Group E) and 38 patients undergoing open esophagectomy (Group O) were investigated.
Arterial blood gas was analysed during two-lung ventilation (TLV) immediately before surgery (T1), during OLV for thoracic procedures (T2), during TLV for abdominal procedures (T3) and during spontaneous breathing immediately before extubation (T4).
Respiratory function data did not differ between the groups, even though the patients were older ( < 0.05) and the operative time was longer ( < 0.01) in Group E than in Group O. At T2, PaO/FO was lower ( < 0.01) and PaCO was higher ( < 0.01) in Group E than in Group O, although these variables did not differ between groups at T1 or T4. Post operative data showed shorter ICU ( < 0.01) and hospital stay ( < 0.05) in Group E than in Group O but showed no significant difference in the presence of complications.
PaO/FO decreased and PaCO increased during OLV for thoracoscopic esophagectomy compared to open esophagectomy. Although thoracoscopic esophagectomy was inferior to open esophagectomy regarding gas exchange during OLV, patients in Group E required less ICU stay and less hospital stay than patients in Group O. The benefits of minimally invasive thoracoscopic esophagectomy may outweigh disadvantages regarding gas exchange during the surgery.
与开放性食管切除术相比，微创胸腔镜食管切除术可能会带来更好的术后效果。我们比较了胸腔镜食管切除术和开放性食管切除术在单肺通气（OLV）期间的动脉血气数据。
对37例行胸腔镜食管切除术的患者（E组）和38例行开放性食管切除术的患者（O组）进行了研究。
在手术前即刻双肺通气（TLV）期间（T1）、胸腔手术OLV期间（T2）、腹部手术TLV期间（T3）以及拔管前自主呼吸期间（T4）分析动脉血气。
尽管E组患者年龄比O组大（<0.05）且手术时间比O组长（<0.01），但两组间呼吸功能数据并无差异。在T2时，E组的PaO/FO低于O组（<0.01），PaCO高于O组（<0.01），尽管这些变量在T1或T4时两组间无差异。术后数据显示，E组的ICU住院时间（<0.01）和住院时间（<0.05）比O组短，但并发症的发生情况无显著差异。
与开放性食管切除术相比，胸腔镜食管切除术在OLV期间PaO/FO降低，PaCO升高。尽管胸腔镜食管切除术在OLV期间的气体交换方面不如开放性食管切除术，但E组患者的ICU住院时间和住院时间比O组患者少。微创胸腔镜食管切除术在手术期间气体交换方面的益处可能超过其弊端。
