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One-lung or two-lung ventilation during transthoracic oesophagectomy?
1Second Department of Surgery, Shimane Medical University, Izumo, Japan.
Summary
One-lung ventilation (OLV) is as safe as two-lung ventilation (TLV) for patients undergoing transthoracic oesophagectomy. While OLV caused greater decreases in oxygen levels and increased shunt ratios, complication rates were similar between groups.
Area of Science:
- Thoracic Surgery
- Anesthesiology
- Respiratory Physiology
Background:
- Transthoracic oesophagectomy requires careful anesthetic management.
- One-lung ventilation (OLV) is often necessary but can impact respiratory function.
Purpose of the Study:
- To evaluate the safety and physiological effects of OLV compared to conventional two-lung ventilation (TLV) during transthoracic oesophagectomy.
Main Methods:
- Thirty patients undergoing transthoracic oesophagectomy were randomized into OLV or TLV groups.
- Circulatory and respiratory variables were monitored during and after surgery.
- Oxygenation (PaO2) and shunt ratios were specifically analyzed.
Main Results:
- The OLV group experienced a significantly greater decrease in PaO2 and a larger increase in shunt ratio compared to the TLV group.
- Despite these physiological differences, other monitored variables and complication rates were comparable between the OLV and TLV groups up to postoperative day 3.
Conclusions:
- One-lung ventilation (OLV) is a safe alternative to two-lung ventilation (TLV) for patients undergoing transthoracic oesophagectomy.
- The observed physiological changes during OLV did not translate to increased complications.