Influence Of One-lung Ventilation On Postoperative Pulmonary Complications In Patients Undergoing One-incision Esophagectomy Via The Left Thoracic Approach

Objective: To investigate the influence of duration during intraoperative one-lung ventilation on postoperative complications and respiratory function in patients undergoing esophagectomy. Methods: Clinical data of 65 patients with esophageal carcinoma resection were retrospectively analyzed from March 2013 to August 2015, All patients underwent continued one-lung ventilation. The patients were divided into group A(Less than 2 hours), group B(2 to 3 hours) and group C(More than 3 hours) based on the duration of one-lung ventilation. One-lung ventilation time, the value of PaO2 and PaCO2 in preoperative(T1), 30 minutes after surgery(T2), and 24 hours after surgery(T3), the number of postoperative pulmonary complications and respiratory failure and postoperative hospital stay were recorded. To analyze the effect of different duration of one-lung ventilation on blood gas indexes, postoperative pulmonary complications and postoperative hospital stay of three groups. Results: The PaO2 value of group A at T3 was significant higher than group C([92.77±14.97] mmHg vs [79.97+9.91] mmHg, P=0.014). The PaO2 value at T1, T2 and the PaCO2 value at T1, T2, T3 of three groups was no significant difference(P>0.05). The incidence rate of pneumonia in group B(61.3%, 19/31) and group C(68.8%, 11/16) was significant higher than group A(22.2%, 4/18, P=0.008, P=0.006). The incidence rate of atelectasis in group C(43.8%, 7/16) was significant higher than group A(5.6%, 1/18, P=0.014). The average postoperative hospital stay in group C(12.88±1.67d) was longer than group A(10.83±1.30 d, P=0.002). The postoperative respiratory failure was no significant difference between the three groups(P>0.05). Conclusion: One-lung ventilation for long time in esophagectomy can increase the incidence of postoperative pulmonary complications and extended postoperative hospital stay.