Single-port thoracoscopic surgery for pneumothorax under twolung ventilation with carbon dioxide insufflation

Kook Nam Han, Hyun Koo Kim, Hyun Joo Lee, Dong Kyu Lee, Heezoo Kim, Sang Ho Lim, Young Ho Choi

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background: The development of single-port thoracoscopic surgery and two-lung ventilation reduced the invasiveness of minor thoracic surgery. This study aimed to evaluate the feasibility and safety of single-port thoracoscopic bleb resection for primary spontaneous pneumothorax using two-lung ventilation with carbon dioxide insufflation. Methods: Between February 2009 and May 2014, 130 patients underwent single-port thoracoscopic bleb resection under two-lung ventilation with carbon dioxide insufflation. Access was gained using a commercial multiple-access single port through a 2.5-cm incision; carbon dioxide gas was insufflated through a port channel. A 5-mm thoracoscope, articulating endoscopic devices, and flexible endoscopic staplers were introduced through a multiple-access single port for bulla resection. Results: The mean time from endotracheal intubation to incision was 29.2±7.8 minutes, the mean operative time was 30.9±8.2 minutes, and the mean total anesthetic time was 75.5±14.4 minutes. There were no anesthesia-related complications or wound problems. The chest drain was removed after a mean of 3.7±1.4 days and patients were discharged without complications 4.8±1.5 days from the operative day. During a mean 7.5±10.1 months of follow-up, there were five recurrences (3.8%) in operated thorax. Conclusions: The anesthetic strategy of single-lumen intubation with carbon dioxide gas insufflation can be a safe and feasible option for single-port thoracoscopic bulla resection as it represents the least invasive surgical option with the potential advantages of reducing operative time and one-lung ventilation-related complications without diminishing surgical outcomes.

Original languageEnglish
Pages (from-to)1080-1086
Number of pages7
JournalJournal of Thoracic Disease
Volume8
Issue number6
DOIs
Publication statusPublished - 2016 Jun 1

Fingerprint

Thoracoscopy
Insufflation
Pneumothorax
Blister
Carbon Dioxide
Ventilation
Operative Time
Lung
Anesthetics
Thoracoscopes
Thorax
Gases
One-Lung Ventilation
Minor Surgical Procedures
Intratracheal Intubation
Intubation
Thoracic Surgery
Anesthesia
Safety
Recurrence

Keywords

  • Anesthesia
  • Minimally invasive surgery
  • Pneumothorax
  • Thoracoscopy/video-assisted thoracoscopic surgery (VATS)
  • Ventilation

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Single-port thoracoscopic surgery for pneumothorax under twolung ventilation with carbon dioxide insufflation. / Han, Kook Nam; Kim, Hyun Koo ; Lee, Hyun Joo; Lee, Dong Kyu; Kim, Heezoo; Lim, Sang Ho; Choi, Young Ho.

In: Journal of Thoracic Disease, Vol. 8, No. 6, 01.06.2016, p. 1080-1086.

Research output: Contribution to journalArticle

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abstract = "Background: The development of single-port thoracoscopic surgery and two-lung ventilation reduced the invasiveness of minor thoracic surgery. This study aimed to evaluate the feasibility and safety of single-port thoracoscopic bleb resection for primary spontaneous pneumothorax using two-lung ventilation with carbon dioxide insufflation. Methods: Between February 2009 and May 2014, 130 patients underwent single-port thoracoscopic bleb resection under two-lung ventilation with carbon dioxide insufflation. Access was gained using a commercial multiple-access single port through a 2.5-cm incision; carbon dioxide gas was insufflated through a port channel. A 5-mm thoracoscope, articulating endoscopic devices, and flexible endoscopic staplers were introduced through a multiple-access single port for bulla resection. Results: The mean time from endotracheal intubation to incision was 29.2±7.8 minutes, the mean operative time was 30.9±8.2 minutes, and the mean total anesthetic time was 75.5±14.4 minutes. There were no anesthesia-related complications or wound problems. The chest drain was removed after a mean of 3.7±1.4 days and patients were discharged without complications 4.8±1.5 days from the operative day. During a mean 7.5±10.1 months of follow-up, there were five recurrences (3.8{\%}) in operated thorax. Conclusions: The anesthetic strategy of single-lumen intubation with carbon dioxide gas insufflation can be a safe and feasible option for single-port thoracoscopic bulla resection as it represents the least invasive surgical option with the potential advantages of reducing operative time and one-lung ventilation-related complications without diminishing surgical outcomes.",
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AU - Kim, Heezoo

AU - Lim, Sang Ho

AU - Choi, Young Ho

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