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One-lung or two-lung ventilation during transthoracic oesophagectomy?

  • Mitsuo Tachibana
  • Shun’ichi Abe
  • Hideki Tabara
  • Hiroshi Yoshimura
  • Hiroshi Matsuura
  • Naofumi Nagasue
  • Teruhisa Nakamura
Reports of Investigation

Abstract

The purpose of this study was to determine the safety of onelung ventilation (OLV) during transthoracic oesophagectomy. Changes in circulatory and respiratory variables during and after operation were compared in patients receiving OLV or conventional two-lung ventilation (TLV). Thirty patients undergoing transthoracic oesophagectomy were randomly divided into either the OLV or the TLV group. During thoracotomy,FiO2 was kept to 1.0. The PaO2 in the OLV group decreased from the prethoracotomy value of 467 ± 84 mmHg to 227 ± 162 mmHg during OLV. This decrease was greater than the decrease from 484 ± 79 mmHg to 380 ± 119 mmHg in the TLV group (P < 0.05). The shunt ratio increased in the OLV group from 20 ± 7% to 35 ± 13% during OLV which was greater than the increase in the TLV group (26 ± 7% from 17 ± 8%) (P < 0.05). Other variables and the incidence of the complications, however, were little different between the two groups during and after OLV and up to POD 3. It is concluded that OLV is as safe as TLV during oesophagectomy.

Key words

anaesthesia: thoracic equipment: tubes, endobronchial 

Résumé

Cette étude vise à évaluer la sécurité de la ventilation unipulmonaire (OLV)pendant l’oesophagectomie transthoraciaue. Les modifications aux variables circulatoires et respiratoire pendant et après l’intervention sont comparées chez des patients en OLV ou sous ventilation conventionnelle bipulmonaire (TLV). Trente patients subissant une oesophagectomie transthoracique sont répartis au hasard entre les groupes OLV et TLV. Pendant la thoracotomie, laFiO2 est maintenue à 1,0. Dans le groupe OLV, la PaO2 baisse pendant l’OLV de la valeur préthoracotomie de 467 ± 84 mmHg à 227 ± 162 mmHg. Cette baisse est plus importante que la baisse de 484 ± 79 mmHg à 380 ± 119 mmHg qui survient dans le groupe TLV (P < 0,05). La fraction de shunt augmente dans le groupe OLV de 20 ± 7% à 35 ± 13% pendant l’OLV, ce qui constitue une augmentation plus importante que l’augmentation constatée dans le groupe TLV (de 17 ± 8% à 26 ± 7%) (P < 0,05). Cependant, les autres variables et l’incidence des complications ne diffèrent pas entre les deux groupes pendant et après OLV jusqu’au troisième jour postopératoire. Pendant l’oesophagectomie, la marge de sécurité est la même entre OLV et TLV.

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Copyright information

© Canadian Anesthesiologists 1994

Authors and Affiliations

  • Mitsuo Tachibana
    • 1
  • Shun’ichi Abe
    • 1
  • Hideki Tabara
    • 1
  • Hiroshi Yoshimura
    • 1
  • Hiroshi Matsuura
    • 1
  • Naofumi Nagasue
    • 1
  • Teruhisa Nakamura
    • 1
  1. 1.Second Department of SurgeryShimane Medical UniversityIzumoJapan

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