scholarly journals OPERATIVE OUTCOMES IN THORACOSCOPIC-ESOPHAGECTOMY WITH TWO-LUNG VENTILATION IN PRONE POSITION

2021 ◽  
Vol 71 (5) ◽  
pp. 1820-23
Author(s):  
Ibrahim Baloch ◽  
Bilal Umair ◽  
Asif Asghar ◽  
Muhammad Imtiaz Khan ◽  
Muhammad Shoaib Hanif
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Prone Position ◽  
Lung Ventilation ◽  
Thoracoscopic Esophagectomy ◽  
Military Hospital ◽  
Anesthesia Induction ◽  
Thoracic Esophagus ◽  
One Lung Ventilation ◽  
Operative Outcomes

Objective: To study the post-operative outcomes of two-lung ventilation in patients undergoing prone position thoracoscopicesophagectomy. Study Design: Prospective comparative study. Place and Duration of Study: Department of Thoracic Surgery, Combined Military Hospital, Rawalpindi Pakistan, from Jan to Dec 2019. Methodology: A total of 60 patients operated for both groups of thoraco-esophagectomy in which 34 patients for TLV (two-lung ventilation) and 26 patients for One-lung ventilation were studied. Patients position was prone for Two-lung ventilation in Thoracoscopic-esophagectomy. Post-op blood loss, Hospital stay, duration of anesthesia and operative morbidity was calculated. Results: A total of 60 patients underwent two-lung ventilation in prone position out of which patient of thoracoscopicesophagectomy were 34, while 26 underwent One-lung ventilation in semi-decubitus position thoracoscopic-esophagectomy. All of them were successfully performed without conversion to open thoracotomy. In the study with preparation span for anesthesia induction, mean time of mobilization of thoracic esophagus, mean blood loss during the thoracic mobilization phase, the mean Intensive care unit stay and total hospital stay in two-lung ventilation was less than one-lung ventilation (p<0.05). Conclusion: The present study summarized the clinical outcomes of two-lung ventilation for thoracoscopic-esophagectomy operated patients. This study data showed that Two-lung ventilation intubation in prone position is better approach during the Thoracoscopic-esophagectomy.

scholarly journals Changes in respiratory mechanics of artificial pneumothorax two-lung ventilation in video-assisted thoracoscopic esophagectomy in prone position

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yoshinori Tanigawa ◽  
Kimihide Nakamura ◽  
Tomoko Yamashita ◽  
Akira Nakagawachi ◽  
Yoshiro Sakaguchi
Keyword(s):  
Esophageal Cancer ◽  
Prone Position ◽  
Respiratory Mechanics ◽  
Lung Ventilation ◽  
Thoracoscopic Esophagectomy ◽  
Secondary Outcome ◽  
One Lung Ventilation ◽  
Cancer Data ◽  
Video Assisted ◽  
Artificial Pneumothorax

AbstractWe aimed to clarify the changes in respiratory mechanics and factors associated with them in artificial pneumothorax two-lung ventilation in video-assisted thoracoscopic esophagectomy in the prone position (PP-VATS-E) for esophageal cancer. Data of patients with esophageal cancer, who underwent PP-VATs-E were retrospectively analyzed. Our primary outcome was the change in the respiratory mechanics after intubation (T1), in the prone position (T2), after initiation of the artificial pneumothorax two-lung ventilation (T3), at 1 and 2 h (T4 and T5), in the supine position (T6), and after laparoscopy (T7). The secondary outcome was identifying factors affecting the change in dynamic lung compliance (Cdyn). Sixty-seven patients were included. Cdyn values were significantly lower at T3, T4, and T5 than at T1 (p < 0.001). End-expiratory flow was significantly higher at T4 and T5 than at T1 (p < 0.05). Body mass index and preoperative FEV1.0% were found to significantly influence Cdyn reduction during artificial pneumothorax and two-lung ventilation (OR [95% CI]: 1.29 [1.03–2.24] and 0.20 (0.05–0.44); p = 0.010 and p = 0.034, respectively]. Changes in driving pressure were nonsignificant, and hypoxemia requiring treatment was not noted. This study suggests that in PP-VATs-E, artificial pneumothorax two-lung ventilation is safer for the management of anesthesia than conventional one-lung ventilation (UMIN Registry: 000042174).

scholarly journals The Use of Oxygen Reserve Index in One-Lung Ventilation and Its Impact On Peripheral Oxygen Saturation, Perfusion Index and Pleth Variability Index

2021 ◽  
Author(s):  
Gonul Sagiroglu ◽  
Ayse Baysal ◽  
Yekta Altemur Karamustafaoglu
Keyword(s):  
Oxygen Saturation ◽  
Pulse Oximetry ◽  
General Anesthesia ◽  
Supine Position ◽  
Lung Ventilation ◽  
Anesthesia Induction ◽  
Pleth Variability Index ◽  
One Lung Ventilation ◽  
Peripheral Oxygen Saturation ◽  
Variability Index

Abstract Background: Our goal is to investigate the use of the Oxygen Reserve Index (ORi) and its relation with peripheral oxygen saturation, perfusion index (PI), and pleth variability index (PVI) during one-lung ventilation (OLV).Methods: Fifty patients undergoing general anesthesia and OLV for elective thoracic surgeries were enrolled in an observational cohort study in a tertiary care teaching hospital. During general anesthesia induction, propofol, fentanyl, and rocuronium at appropriate doses were administered intravenously. All patients required OLV after a left-sided double-lumen tube insertion during intubation. Hypoxemia during OLV was defined as peripheral oxygen saturation (SpO2) value of less than 95% when the inspired oxygen fraction (FiO2) is above 60% on a pulse oximetry device. ORi, pulse oximetry, PI, and PVI were measured continuously. Sensitivity, specificity, positive and negative predictive values, likelihood ratios, and accuracy were calculated for ORi equals zero in different anesthesia time points to predict hypoxemia. At Clinicaltrials.gov registry, the Registration ID is NCT05050552.Results: The accuracy for predicting hypoxemia during anesthesia induction at ORi value equals zero at five minutes after intubation in the supine position (DS5) showed a sensitivity of 92.3% (95% CI 84.9-99.6), specificity of 81.1% (95% CI 70.2-91.9), and an accuracy of 84.0% (95% CI 73.8- 94.2). ORi and SpO2 correlation was found at DS5 (p = 0.044), 5 minutes after lateral position with two-lung ventilation (DL5) (p = 0.039), and at 10 minutes after OLV (OLV10)(p = 0.011).Conclusions: ORi equals zero at the time point of five minutes after tracheal intubation in the supine position (DS5) showed high sensitivity and specificity for predicting hypoxemia at a less than 95% value.

The use of harmonic scalpel in open thyroid surgery: Is it rewarding?

2016 ◽  
Author(s):  
Ghazi Qasaimeh ◽  
Yousef Khader ◽  
Hamzeh Balas ◽  
Motaz Qasaimeh
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Thyroid Surgery ◽  
Retrospective Review ◽  
Harmonic Scalpel ◽  
Average Duration ◽  
Operation Time ◽  
Open Thyroidectomy ◽  
Operative Outcomes ◽  
Duration Of Operation

Abstract Objectives: To evaluate the advantages and effectiveness of the harmonic scalpel (HS) in open thyroid surgery. Background: Haemostasis is the most important factor for successful thyroid surgery. Our aim was to compare the effect of the use of harmonic scalpel versus the conventional haemostasis (CH) methods during open thyroidectomy in the intra-operative and post-operative outcomes. Methods: A retrospective review of all total thyroidectomy operations performed in six years was done. The patients were divided in two groups: The CH group and the HS group according to the method used. Information regarding patient's age, sex, pathological diagnosis, operations details, operations duration, the blood loss, the use of drains and the complications were recorded. Results: Out of 239 operations performed, 143 operations were in the CH group and 96 operations were in the HS group. The average duration of operation was 73minutes in the HS group vs. 97minutes in the CH group, p-&gt;0.005. Blood loss was less in the HS group, p- 0.014 with fewer drains, p-&lt; 0.005. Transient hypocalcaemia (TH) was less in the HS group (12.5% vs. 25.9%, p- 0.012). The hospital stay was less in the HS group (3.4 days vs. 3.9 days, p- 0.001). The use of HS was more costly. Conclusion: HS use in thyroid surgery reduces: operation time, blood loss, use of drains, post-operative TH and hospital stay. It is more costly but the advantages of its use in a busy hospital offset this drawback.

Robotic and Laparoscopic Approaches for Adrenal Surgery in Obese Patients

2020 ◽  
pp. 000313482095149
Author(s):  
Hosam Shalaby ◽  
Mohamed Abdelgawad ◽  
Mahmoud Omar, MD ◽  
Ghassan Zora, MD ◽  
Saad Alawwad ◽  
...  
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Operative Time ◽  
Laparoscopic Approach ◽  
Obese Patients ◽  
Adrenal Surgery ◽  
Robotic Approach ◽  
Robot Assisted ◽  
Operative Outcomes ◽  
Estimated Blood Loss

Objective Minimally invasive adrenalectomy is a challenging procedure in obese patients. Few recent studies have advocated against robot-assisted adrenalectomy, particularly in obese patients. This study aims to compare operative outcomes between the robotic and laparoscopic adrenalectomy, particularly in obese patients. Materials and Methods A retrospective analysis was performed on all consecutive patients undergoing adrenalectomy for benign disease by a single surgeon using either a laparoscopic or robotic approach. Adrenal surgeries for adrenal cancer were excluded. Demographics, operative time, length of hospital stays, estimated blood loss (EBL), and intraoperative and postoperative complications were evaluated. Patients were divided into 2 groups; obese and nonobese. A sub-analysis was performed comparing robotic and laparoscopic approaches in obese and nonobese patients. Results Out of 120, 55 (45.83%) were obese (body mass index ≥ 30 kg/m2). 14 (25.45%) of the obese patients underwent a laparoscopic approach, and 41 (74.55%) underwent a robotic approach. Operative times were longer in the obese vs. nonobese groups (173.30 ± 72.90 minutes and 148.20 ± 61.68 minutes, P = .04) and were associated with less EBL (53.77 ± 82.48 vs. 101.30 ± 122, P = .01). The robotic approach required a longer operative time when compared to the laparoscopic approach (187 ± 72.42 minutes vs. 126.60 ± 54.55 minutes, P = .0102) in the obese but was associated with less blood loss (29.02 ± 51.05 mL vs. 138.30 ± 112.20 mL, P < .01) and shorter hospital stay (1.73 ± 1.23 days vs. 3.17 ± 1.27 days, P < .001). Conclusion Robot-assisted adrenal surgery is safe in obese patients and appears to be longer; however, it provides improvements in postoperative outcomes, including EBL and shorter hospital stay.

scholarly journals The Comparison of the Effects of Sevoflurane Inhalation Anesthesia and Intravenous Propofol Anesthesia on Oxidative Stress in One Lung Ventilation

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Engin Erturk ◽  
Selma Topaloglu ◽  
Davut Dohman ◽  
Dilek Kutanis ◽  
Ahmet Beşir ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Thoracic Surgery ◽  
Ischemia Reperfusion Injury ◽  
Ischemia Reperfusion ◽  
Lung Ventilation ◽  
Anesthesia Induction ◽  
Blood Gas ◽  
One Lung Ventilation ◽  
Inhalation Anesthesia ◽  
Blood Samples

Background. The aim of this study is to compare the effects of sevoflurane and propofol on one lung ventilation (OLV) induced ischemia-reperfusion injury (IRI) by determining the blood gas, ischemia-modified albumin (IMA), and malonyldialdehyde (MDA).Material and Methods. Forty-four patients undergoing thoracic surgery with OLV were randomized in two groups (sevoflurane Group S, propofol Group P). Anesthesia was inducted with thiopental and was maintained with 1–2.5% of sevoflurane within the 40/60% of O2/N2O mixture in Group S. In Group P anesthesia was inducted with propofol and was maintained with infusion of propofol and remifentanil. Hemodynamic records and blood samples were obtained before anesthesia induction (t1), 1 min before two lung ventilation (t2), 30 min after two lung ventilation (t3), and postoperative sixth hours (t4).Results. Heart rate att2andt3in Group P was significantly lower than that in Group S. While there were no significant differences in terms of pH and pCO2, pO2att2andt3in Group S was significantly lower than that in Group P. IMA levels att4in Group S were significantly lower than those in Group P.Conclusion. Sevoflurane may offer protection against IRI after OLV in thoracic surgery.

Paediatric one lung ventilation in the prone position

1997 ◽  
Vol 7 (5) ◽  
pp. 427-429 ◽  
Author(s):  
M.W.H TURNER ◽  
C.C.R BUCHANAN ◽  
S.W BROWN
Keyword(s):  
Prone Position ◽  
Lung Ventilation ◽  
One Lung Ventilation

scholarly journals Pediatric Lung isolation in a limited resource setup: a case report

2019 ◽  
pp. e270
Author(s):  
Pankaj Baral ◽  
Jagat Narayan Prasad ◽  
Sabin Bhandari ◽  
Pratistha Thapa
Keyword(s):  
Endotracheal Tube ◽  
Lung Ventilation ◽  
Limited Resource ◽  
Lateral Position ◽  
Double Lumen Tube ◽  
Anesthesia Induction ◽  
Fiberoptic Bronchoscope ◽  
One Lung Ventilation ◽  
Lung Isolation ◽  
Left Lateral Position

Rationale: Pediatric lung isolation is a great challenge to an anesthesiologist. Despite various advances in techniques and equipment in lung isolation, most of the sophisticated devices are unavailable in remote setups. Blind techniques have been used, but they have a low success rate. Patient concerns: Here we report a case of a five year old male child who had cough and fever for one month. CT scan of chest revealed right sided empyema thoracis for which decortication was planned under general anaesthesia with one lung ventilation. Double lumen tube for this patient was not commercially available and we did not have a paediatric fiberoptic bronchoscope, which would fit inside the endotracheal tube necessary for the patient. Interventions: After anesthesia induction, an adult fiberoptic bronchoscope was used as an aid for insertion of bougie into the left mainstem bronchus followed by rail roading the endotracheal tube over the bougie for lung isolation. Outcomes: Surgery then proceeded in left lateral position with a right thoracotomy under a quiet surgical field. Conclusion: In case of unavailability of paediatric fiberoptic bronchoscope, an adult fiberoptic bronchoscope and a bougie can aid in successful lung isolation in paediatric patients.

Sign in / Sign up

Export Citation Format

Share Document