A Comparison of Arterial Blood Gas Data Between Open Esophagectomy and Thoracoscopic Esophagectomy

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 (p < 0.05) and the operative time was longer (p < 0.01) in Group E than in Group O. At T2, PaO₂/F_IO₂ was lower (p < 0.01) and PaCO₂ was higher (p < 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 (p < 0.01) and hospital stay (p < 0.05) in Group E than in Group O but showed no significant difference in the presence of complications.

PaO₂/F_IO₂ decreased and PaCO₂ 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.