Apneic Oxygenation for Contralateral Uniportal Multiple Lung Resection After Right Pneumonectomy

Anesthetic management for thoracic surgery in patients with single-lung physiology is challenging when mechanical ventilation is not possible or limited. Apneic oxygenation maintains oxygenation during apnea, facilitating lung collapse and optimal surgical exposure. We report a 50-year-old man with bilateral lung metastases from osteosarcoma who underwent left lung wedge resection 10 days after right pneumonectomy, using apneic oxygenation instead of conventional one-lung ventilation. This case demonstrates that apneic oxygenation may serve as a safe and effective alternative in selected patients. However, limitations such as hypercapnia and respiratory acidosis require careful patient selection, time constraints, and vigilant intraoperative monitoring.