Single-port thoracoscopic surgery for pneumothorax under two-lung ventilation with carbon dioxide insufflation

Han, Kook Nam; Kim, Hyun Koo; Lee, Hyun Joo; Lee, Dong Kyu; Kim, Heezoo; Lim, Sang Ho; Choi, Young Ho

doi:10.21037/asvide.2016.226

Cited by 3 publications

(4 citation statements)

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“…In contrast, induction of CDI is technically simple compared with OLV and is easily induced in cats by using commercially available mechanical insufflators. Studies in humans have provided evidence that single lumen intubation and CDI may decrease operative times and remove the complications associated with OLV . The principal objective of this study was to evaluate the effect that CDI induced at varying levels of ITP on cardiopulmonary variables in cats undergoing VATS.…”

Section: Discussionmentioning

confidence: 99%

Cardiorespiratory effects of variable pressure thoracic insufflation in cats undergoing video‐assisted thoracic surgery

et al. 2018

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Objective: To evaluate the effects of intrathoracic insufflation on cardiorespiratory variables and working space in cats undergoing video-assisted thoracic surgery. Study design: Prospective randomized study. Animals: Six healthy cats. Methods: Cats were anesthetized using a standardized protocol. A Swan-Ganz catheter was positioned in the pulmonary artery under fluoroscopic guidance for measurement of cardiac output. Intrathoracic pressures (ITP) of 0 (baseline), 3, and 5 mm Hg were induced with CO 2 and maintained for 30 minutes. Statistical comparison of cardiorespiratory variables was performed. After the procedures, all cats were recovered from anesthesia. Videos of thoracic working space at each ITP level were scored in a blinded fashion by 3 board-certified surgeons using a numerical scale from 0-10. Results: All cats tolerated insufflation with 3 and 5 mm Hg for 30 minutes without oxygen desaturation, although ventilatory levels had to be increased substantially to maintain eucapnia and oxygenation. Cardiac index was not significantly different from baseline after 30 minutes at 3 mm Hg but was significantly lower after 30 minutes at 5 mm Hg compared with 3 mm Hg. Oxygen delivery was unaffected by 3 or 5 mm Hg compared with baseline. Scores for working space increased between baseline and 3 and 5 mm Hg but were not different between 3 and 5 mm Hg. Conclusion: CO 2 insufflation to 5 mm Hg seems well tolerated in healthy cats, provided ventilatory settings are substantially increased as ITP increases. Clinical significance: Thoracic CO 2 insufflation of 3 mm Hg in cats during videoassisted thoracic surgery is associated with less hemodynamic perturbation than 5 mm Hg insufflation and may provide the benefit of improved working space compared with baseline.

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Section: Discussionmentioning

confidence: 99%

Cardiorespiratory effects of variable pressure thoracic insufflation in cats undergoing video‐assisted thoracic surgery

et al. 2018

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“…However, these changes can be problems if the surgery lasts longer than expected or when the patient is at risk of abnormal ventilation, even from subtle changes. Most articles on SITS bleb resection focused on the feasibility of that surgery without objective evidence (3,4,13,16). They reported the feasibility of SITS with CO 2 insufflation in terms of operation time, anesthesia time, postoperative complications, hospital stay, subjective operation field evaluation and physiologic changes (3,4,13).…”

Section: Discussionmentioning

confidence: 99%

“…Most articles on SITS bleb resection focused on the feasibility of that surgery without objective evidence (3,4,13,16). They reported the feasibility of SITS with CO 2 insufflation in terms of operation time, anesthesia time, postoperative complications, hospital stay, subjective operation field evaluation and physiologic changes (3,4,13). One author reported that a feasible surgical field could be acquired using a bidirectional anchoring suture during single-port thoracoscopic surgery without CO 2 (17).…”

Section: Discussionmentioning

confidence: 99%

“…VATS under small-tidal TLV (ST-TLV) is a proven alternative to OLV for bleb resection (13), and we reported adequate ventilator settings for ST-TLV during VATS bleb resection (14). The feasibility of CO 2 insufflation with ST-TLV to ensure an appropriate surgical field was demonstrated (3). However, CO 2 insufflation has potential complications including arterial hypercapnia and related cardiovascular response, CO 2 embolism, and hypotension resulting from impaired venous return (15).…”

Section: Introductionmentioning

confidence: 99%

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CO2 during single incisional thoracoscopic bleb resection with two-lung ventilation

Lee

Kim

et al. 2018

J. Thorac. Dis.

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