Application of self-made extended endobronchial tube in thoracoscopic surgery for esophageal cancer

Abstract

Objective To observe the feasibility and safety of self-made extended endobronchial tube applicated in one-lung ventilation for radical resection of esophageal cancer. Methods 80 patients were randomly divided into two groups: self-made extended endobronchial tube group (group A) and double-lumen endobronchial tube group (group B). The degree of lung collapse, systolic blood pressure, diastolic blood pressure, heart rate, airway pressure (Paw), arterial partial pressure of oxygen(PaO2), arterial partial pressure of carbon dioxide(PaCO2), arterial oxygen saturation (SaO2) were monitored.The time for insertion, rate of successfully intubation for single time, incidence of postoperative hoarseness and sore throat were recorded. Results There were no significant differences in degree of lung collapse, systolic blood pressure, diastolic blood pressure and heart rate, SaO2 in the two groups(all P>0.05). The comparison of the time for insertion between the two groups: (1.5±0.4)min vs.(2.6±0.8)min(t=4.78, P<0.05); rates of successfully intubation for single time: 95.0% vs.80.0%(χ2=5.19, P<0.05). The comparison of Paw between the two groups: T1: (17.3±1.1)cmH2O vs.(22.5±0.9)cmH2O, t=4.613, P<0.05; T2: (17.9±0.5)cmH2O vs.(23.6±1.4)cmH2O(t=5.438, P<0.05); T3: (18.1±0.8)cmH2O vs.(24.6±1.2)cmH2O(t=3.741, P<0.05). The comparison of blood gas during one-lung ventilation between the two groups: PaO2(281.5±53.4)mmHg vs.(187.6±48.8)mmHg(t=5.28, P<0.05); SaO2(98.1±6.3)% vs.(94.5±5.7)%(t=3.46, P<0.05); PaCO2(31.2±3.6)mmHg vs.(37.6±4.1)mmHg(t=6.32, P<0.05). The comparison of incidence of postoperative hoarseness: 1case vs.6cases(χ2=5.91, P<0.05); The comparison of incidence of sore throat: 4cases vs.13cases(χ2=6.13, P<0.05). Conclusion Single-lung ventilation has achieved via either the double lumen tube or the self-made extended endobronchial tube.However, the self-made extended endobronchial tube is recommended for single-lung ventilation because of the advantages of its easy intubation and position, full oxygenation, low Paw, less incidence of postoperative hoarseness and sore throat.Self-made extended endobronchial tube can be used as a one-lung ventilation method in its indications. Key words: Esophageal neoplasms; Esophagectomy; Thoracoscopy