The application of single-lumen endotracheal tube anaesthesia with artificial pneumothorax in thoracolaparoscopic oesophagectomy

Interact Cardiovasc Thorac Surg. 2014 Aug;19(2):308-10. doi: 10.1093/icvts/ivu100. Epub 2014 Apr 15.

Abstract

Double-lumen endotracheal tube (DLET) anaesthesia is the commonly used method in minimally invasive oesophagectomy (MIE). However, DLET intubation does have its disadvantages. Firstly, the placement of the DLET needs a skilled anaesthetist with familiarity of the technique and subsequent ability to perform a fibre-optic bronchoscopy for confirmation. Secondly, DLET intubation and one-lung ventilation are associated with numerous complications, including hoarseness, tracheobronchial injury and vocal injury. In this report, a retrospective analysis was performed on 42 consecutive patients who underwent MIE using single-lumen endotracheal tube (SLET) anaesthesia with CO2 artificial pneumothorax compared with 81 patients who underwent the same procedure with DLET intubation. Our findings showed that SLET intubation with artificial pneumothorax by CO2 insufflation is a feasible and safe method for MIE procedures.

Keywords: Artificial pneumothorax; Double-lumen endotracheal tube; Minimally invasive oesophagectomy; Single-lumen endotracheal tube; Thoracolaporoscopic oesophagectomy.

MeSH terms

  • Aged
  • Anesthesia, General / adverse effects
  • Anesthesia, General / instrumentation*
  • Anesthesia, General / methods
  • Chest Tubes*
  • Equipment Design
  • Esophageal Neoplasms / surgery*
  • Esophagectomy / methods*
  • Female
  • Humans
  • Insufflation
  • Intubation, Intratracheal / adverse effects
  • Intubation, Intratracheal / instrumentation*
  • Laparoscopy*
  • Male
  • Middle Aged
  • One-Lung Ventilation
  • Pneumothorax, Artificial* / adverse effects
  • Retrospective Studies
  • Thoracoscopy*
  • Treatment Outcome