Operative Benefits of Artificial Pneumothorax in Thoracoscopic Esophagectomy in the Left Lateral Decubitus Position for Esophageal Cancer

Takemura, Masashi; Kaibe, Nobuaki; Takii, Michiaki; Sasako, Mitsuru

doi:10.4236/ijcm.2015.612127

Cited by 3 publications

(2 citation statements)

References 23 publications

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“…The establishment of CO 2 artificial pneumothorax has been shown to provide better surgical field. [ 2 ] The current method of choice for lung ventilation during thoracoscopic esophagectomy is single-lumen endotracheal tube intubation with the establishment of a CO 2 artificial pneumothorax and bilateral lung ventilation. In 2006, Palanivelu et al introduced CO 2 artificial pneumothorax, which is an approach of anesthesia intubation in thoracoscopic esophagectomy with the two-lung ventilation approach.…”

Section: Introductionmentioning

confidence: 99%

CO2 artificial pneumothorax on coagulation and fibrinolysis during thoracoscopic esophagectomy

Ren

Yan

et al. 2021

Medicine

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Background: CO2 artificial pneumothorax creates a sufficient operative field for thoracoscopic esophagectomy. However, it has potential complications and continuous CO2 insufflation may impede coagulation and fibrinolysis. We sought to compare the effects of CO2 artificial pneumothorax on perioperative coagulation and fibrinolysis during thoracoscopic esophagectomy. Methods: We investigated patients who underwent thoracoscopic esophagectomy with (group P, n = 24) or without CO2 artificial pneumothorax (group N, n = 24). The following parameters of coagulation–fibrinolysis function: intraoperative bleeding volume; serum levels of tissue plasminogen activator (t-PA), plasminogen activator inhibitor (PAI-1), thromboelastogram (TEG), D-Dimer; and arterial blood gas levels were compared with two groups. Results: Group P showed higher levels of PaCO2, reaction time (R) value and kinetics (K) value, but significantly lower pH value, alpha (α) angle and Maximum Amplitude (MA) value at 60 minutes after the initiation of CO2 artificial pneumothorax than group N ((P < .05, all). The t-PA level after CO2 insufflation for 60 minutes was significantly higher in group P than in group N (P < .05), but preoperative levels were gradually restored on cessation of CO2 insufflation for 30 min (P > .05). There was no significant difference in D-dimer. Conclusion: CO2 artificial pneumothorax during thoracoscopic esophagectomy had a substantial impact on coagulation and fibrinolysis, inducing significant derangements in pH and PaCO2. Trial registration: The study was registered at the Chinese clinical trial registry (ChiCTR1800019004)

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Section: Introductionmentioning

confidence: 99%

CO2 artificial pneumothorax on coagulation and fibrinolysis during thoracoscopic esophagectomy

Ren

Yan

et al. 2021

Medicine

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“…The working space in the thoracic cavity is secured by the bony thorax; therefore, insufflation is not always necessary as compared to abdominal surgeries. However, the induction of artificial pneumothorax has many intraoperative advantages, such as a good exposure of the surgical field [1][2][3][4], control of blood loss [4], and easier detachment by the pneumothorax pressure. It also offers other advantages during anesthesia, such as the ability to perform surgery with double-lung ventilation [1,3].…”

Section: Introductionmentioning

confidence: 99%

Artificial pneumothorax suppresses postoperative inflammatory reaction in mediastinal tumor surgery

Ito

Tsukioka

Izumi

et al. 2021

Gen Thorac Cardiovasc Surg

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Objective: The induction of artificial pneumothorax has many intraoperative advantages. However, few reports on the postoperative effects of artificial pneumothorax induction are available. In this study, we investigated the effect of artificial pneumothorax on postoperative clinical course in patients with mediastinal tumors. Methods:We retrospectively investigated the clinical courses of 89 patients who had undergone mediastinal tumor resection between January 2010 and December 2020.Sixty-five patients had undergone resection with artificial pneumothorax. Results:The tumor location significantly varied across patients. The proportion of patients in whom artificial pneumothorax was induced was higher among those having anterior mediastinal tumors. The number of ports and the total skin incision length were significantly higher in patients without artificial pneumothorax. The C-reactive protein level elevation on postoperative day2 and pleural effusion at 24 hours after surgery were significantly higher in patients without artificial pneumothorax. Furthermore, the albumin level reduction and hospital stay after surgery were significantly lower in patients with artificial pneumothorax. Multiple regression analysis showed that the use of artificial pneumothorax was an independent predictive factor of the C-reactive 4 protein level elevation on postoperative day 2 and pleural effusion at 24 hours after surgery. In patients without artificial pneumothorax, the operation time positively correlated with the C-reactive protein level (r=0.646, P<0.001).Conclusions: Artificial pneumothorax suppressed the postoperative inflammatory response, pleural effusion, and albumin reduction, and shortened the hospital stay in patients undergoing mediastinal tumor surgery.

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Clinical Results of Endoscopic Balloon Dilatation for Treatment of Anastomotic Leakage after Esophagectomy for Esophageal Cancer

Takemura¹

2017

The Journal of the Japan Broncho-esophagological Society

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Operative Benefits of Artificial Pneumothorax in Thoracoscopic Esophagectomy in the Left Lateral Decubitus Position for Esophageal Cancer

Cited by 3 publications

References 23 publications

CO2 artificial pneumothorax on coagulation and fibrinolysis during thoracoscopic esophagectomy

CO2 artificial pneumothorax on coagulation and fibrinolysis during thoracoscopic esophagectomy

Artificial pneumothorax suppresses postoperative inflammatory reaction in mediastinal tumor surgery

Clinical Results of Endoscopic Balloon Dilatation for Treatment of Anastomotic Leakage after Esophagectomy for Esophageal Cancer

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