Video-Assisted Thoracic Surgery Under Epidural Anesthesia -in High-Risk Group.
- Author:
Song Ahm LEE
1
;
Kwang Taik KIM
;
Il Hyun KIM
;
Sung Min PARK
;
Man Jong BAEK
;
Kyung SUN
;
Hyoung Mook KIM
;
In Sung LEE
Author Information
1. Department of Thoracic and Cardiovascular Surgery, College of Medicine, Korea University, Seoul. ktkim@kuccnx.korea.ac.kr
- Publication Type:Original Article
- Keywords:
Risk factor;
Epidural anesthesia;
Thoracoscopy
- MeSH:
Anesthesia, Epidural*;
Anesthesia, General;
Diagnosis;
Empyema;
Humans;
Hyperhidrosis;
Lung;
Lung Diseases;
One-Lung Ventilation;
Operative Time;
Pleural Effusion;
Pneumothorax;
Recurrence;
Respiration;
Risk Factors;
Thoracic Surgery, Video-Assisted*;
Thoracoplasty;
Thoracoscopy
- From:The Korean Journal of Thoracic and Cardiovascular Surgery
1999;32(8):732-738
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Video-assisted thoracoscopic surgery has become a standard therapy for several diseases such as pneumothorax, hyperhidrosis, mediastinal mass, and so on. These methods usually required single-lung ventilation with double-lumen endobronchial tube to collapse the lung under general anesthesia. However, risks of general anesthesia itself and single-lung ventilation must be considered in high-risk patients. MATERIAL AND METHOD: Between December 1997 and July 1998, eight high-risk patients (6: empyema, 1: intractable pleural effusion, 1: idiopathic pulmonary fibrosis) with underlying pulmonary disease and poor general condition were treated by video-assisted thoracoscopic surgerys under epidural anesthesia and spontaneous breathing. RESULT: Video-assisted thoracoscopic surgerys were successfully per formed in 7 patients. Conversion to general anesthesia was required in 1 patient because of decrease in spontaneous breathing. But, conversion to open decortication was not required. In two patients with chronic empyema, one patient required thoracoplasty as a second procedure and one patient required re-video-assisted thoracoscopic procedure due to a recurrence. The mean operative time was 31.8+/-15.2 minutes. No significant postoperative respiratory com plication was encountered. CONCLUSION: Video-assisted thoracoscopic surgerys can be per formed safely under epidural anesthesia for the treatment of empyema and diagnosis of pulmonary abnormalities in high-risk patients.
