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Abstract
BackgroundEsophageal cancer has a poor prognosis. Surgery is the main treatment but involves a high risk of complications. Some surgical strategies have tried to eliminate complications. Our meta-analysis tried to find the benefits of single-lumen endotracheal tube intubation with carbon dioxide (CO2) inflation.MethodsA systematic search of studies on esophagectomy and CO2 inflation was conducted using PubMed, Medline, and Scopus. The odds ratio of post-operative pulmonary complications and anastomosis leakage were the primary outcomes. The standardized mean difference (SMD) in post-operative hospitalization duration was the secondary outcome.ResultsThe meta-analysis included four case-control studies with a total of 1503 patients. The analysis showed a lower odds ratio of pulmonary complications in the single-lumen endotracheal tube intubation in the CO2 inflation group (odds ratio: 0.756 [95% confidence interval, CI: 0.518 to 1.103]) compared to that in the double-lumen endotracheal tube intubation group, but anastomosis leakage did not improve (odds ratio: 1.056 [95% CI: 0.769 to 1.45])). The SMD in hospitalization duration did not show significant improvement. (SMD: -0.141[95% CI: − 0.248 to − 0.034]).ConclusionsSingle-lumen endotracheal tube intubation with CO2 inflation improved pulmonary complications and shortened the hospitalization duration. However, no benefit in anastomosis leakage was observed.
Highlights
IntroductionOur meta-analysis tried to find the benefits of single-lumen endotracheal tube intubation with carbon dioxide (CO2) inflation
Some studies focused on the anesthesia method with single-lumen endotracheal tube intubation with artificial pneumothorax induced by carbon dioxide (CO2) inflation
Search strategy and inclusion criteria PubMed, Medline, and Scopus were searched for studies with keywords including “artificial pneumothorax or CO2” and “esophagectomy or Video-assisted thoracoscopic surgery (VATS).”
Summary
Our meta-analysis tried to find the benefits of single-lumen endotracheal tube intubation with carbon dioxide (CO2) inflation. Some studies focused on the anesthesia method with single-lumen endotracheal tube intubation with artificial pneumothorax induced by carbon dioxide (CO2) inflation. We knew single lumen intubation is benefit in minimal invasive esophagectomy to approach lymph nodes around left recurrent laryngeal nerve and some published studies adopted this surgical intervention [2]. Minimally invasive esophagectomy performed by single lumen intubation is a trend to get better exposure of left recurrent laryngeal nerve injury. It remains some debate between using carbon dioxide insufflation or not. Our meta-analysis tried to compare single-lumen endotracheal tube intubation anesthesia plus CO2 inflation with double-lumen endotracheal tube intubation
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