Study on the lung protective ventilation strategy of artificial pneumothorax in full laparoscopic radical resection of esophageal cancer
- VernacularTitle:人工气胸在全腔镜食管癌根治术肺保护性通气策略中的应用研究
- Author:
Chunhui HU
1
;
Chao CHEN
;
Zhentao SUN
Author Information
- Keywords: artificial pneumothorax; full laparoscopic radical resection of esophageal cancer; lung protective ventilation strategy; lung recruitment; inflammatory reaction
- From: China Journal of Endoscopy 2024;30(9):9-16
- CountryChina
- Language:Chinese
- Abstract: Objective To explore the effect of lung protective ventilation strategy in artificial pneumothorax in full laparoscopic radical resection of esophageal cancer.Methods 88 patients were selected from January 2021 to March 2023 for the treatment of artificial pneumothorax with full laparoscopic radical resection of esophageal cancer.They were randomly divided into two groups.44 patients underwent conventional ventilation as the control group,and 44 patients underwent lung-protective ventilation strategy as the experimental group,and the different effects produced by the above different ventilation modes were analyzed.Results There were no significant differences in pH and partial pressure of carbon dioxide(PCO2)between the experimental group and the control group at the 10 min after endotracheal intubation(T1),1 h after single lung ventilation(T2),after surgery(T3),and 24 h after surgery(T4)(P＞0.05).The oxygenation index at the time points of T1,T2,T3 and T4,there were significant differences between the two groups(P＜0.05).The experimental group and the control group had significant differences in static lung compliance(Cs),plateau pressure(Pplat),and peak airway pressure(Ppeak)at the T1,T2,and T3 time points(P＜0.05).At T1,there were no significant differences in the levels of C-reaction protein(CRP),tumor necrosis factor-α(TNF-α),interleukin-8(IL-8),and interleukin-6(IL-6)between the experimental group and the control group at the time points(P＞0.05).There were significant differences of the above indicators between the two groups at T2,T3,and T4 time points(P＜0.05);The incidence of pulmonary complications was 25.00％in the control group compared with 9.09％in the experimental group,there was a significant difference(P＜0.05).Conclusion Tidal volume(VT)6 mL/kg+100.00％inhaled oxygen concentration+positive end-expiratory pressure 5 cmH2O+recruitment lung protective ventilation strategy used in artificial pneumothorax for full laparoscopic radical resection of esophageal cancer can significantly reduce intraoperative airway pressure and inhibit inflammatory reaction and increase ventilation safety.
