The Study Of Security And Feasibility Of Single Lumen Endotracheal Intubation And Continaons Carbon Dioxide（CO₂） Insufflation In The Endoscopy In Esophageal Cancer Radical

Objective:To compare the records of respiratory and circulatory of the application of the single lumen endotracheal intubation and continaons carbon dioxide(CO2) insufflation with the double-cavity tube endotracheal intubation in patients with the esophageal cancer, and evaluate the safety,feasibility and postoperative complications.Methods:120 patients underwent a thoracoscopic and laparoscopic esophagetomy for esophageal cancer were collected from The 174th Hospital of AnHui Medical University. All patients were diagnosed with the middle and lower esophagus cancer by CT and no severe respiratory and circulatory problems. Patients aged 39-70 years old, ASA Ⅰ～Ⅲ level, male and female there is no limit.120 patients were assigned into two group according to the type of the trachea intubation, single lumen endotracheal intubation group (group s) and double lumen tube group (group D) with 60 patients each. HR, MAP, SpO2, Ppeak, PETCO2,blood gas analysis and the other record of respiratory and circulatory were monitored in five time point. i.e. before the anesthesia (T1),20 minutes the fixed the endotracheal intubation successfully (T2),20minutes after the right lung collapsed(T3),60 minutes after the right lung collapsed and 30 minutes after ventilation of both lung. After all of these, Qs/Qt were calculated.Results:Demographic characteristics, the quality and the time of the right lung collapsed and the surgery time were no statistically significant difference. During the surgery the BP, HR, SpO2 were in normal rang and were no statistically difference. Compared with group D, table 3 shows that on T3 and T4, pH and Qs/Qt were lower,but PaO2, PaCO2, PETCO2 were obviously higher. Ppeak was in no difference in all time points. Table 4 shows that the number of times of fixing the catheter,the success rate of intubation and the frequency of the injury of throat and mucosa is significant higher, but the change ratio of displacement of the catheter, the rate of collapsing of both lung were more than group D. As shows in table 5, the incidence and severity of postoperative hoarseness and sore throat were more obviously observed in the group D. The incidence of postoperative pulmonary complications were in no difference in two groups. However, PaCO2 of the patients of group S was been seen elevated, and 2 cases of the patients were severe acidosis and hypercapnia, PaCO2 level was been observed in 89.26mmHg. The pH was lower out of normal. In both group, Ppeak in T3 and T4 is higher than the T2 and T5. The calculation of Qs/Qt in one-lung ventilation was higher than two-lung, and there are of statistically difference in two groups, especially in group D.Conclusions:The single lumen endotracheal in tubation and continuous carbon dioxide insufflation is a new method of Anesthesia in the surgery of the esophageal canceer, it can be used in most of the patients with esophageal cancer, but for the patient with the low blood volume and left cardiac insufificiency and preoperative oxygenation index of less than 300mmHg had better choose the double-cavity tube endotracheal intubation and closely observe the procedure of the surgery.