Comparison of Clinical Problems in Thoracoscopic Esophagectomy between Prone Position with Pneumothorax Procedure and Lateral Position ()
ABSTRACT
Study Objective: We compared the effects of intraoperative body position on blood gas and fluid
balance in patients undergoing a thoracoscopic esophagectomy as well as during
operation and postoperative laboratory data. Design: Prospective study. Setting: Operating room
and intensive care unit. Patients: ASA physical
status 1 and 2 patients (n = 26), scheduled for elective thoracoscopic
esophagectomy and immediate reconstruction under general anesthesia with
one-lung ventilation were enrolled. Interventions: Patients were assigned to either the lateral (n = 16) or prone (n = 10)
position groups based on the planned intraoperative body position. A
pneumothorax procedure was concomitantly performed only in the prone position
group. Measurements: Fluid balance,
PaO2/FIO2 ratio (P/F ratio), and maximum PaCO2 during the operation and postoperative laboratory data were analyzed. Main Results: There were no significant
differences between the groups for amount of blood loss, blood transfusion,
fluid infusion, or urine output. The P/F ratio during one-lung ventilation was
significantly higher in the prone than the lateral position group (379 ± 122 vs.
297 ± 67 mmHg, p = 0.017), as was maximum intraoperative PaCO2 (72.2
± 15.6 vs. 48.3 ± 6.3 mmHg, p < 0.001). Conclusions: A thoracoscopic esophagectomy in the prone position performed concomitantly
with a CO2 pneumothorax procedure resulted in a significantly better
P/F ratio during one-lung ventilation as compared to the lateral position,
indicating that the prone position is more advantageous for oxygenation.
Share and Cite:
Y. Kasagi, R. Okutani, Y. Komatsu, Y. Oda and Y. Yamashita, "Comparison of Clinical Problems in Thoracoscopic Esophagectomy between Prone Position with Pneumothorax Procedure and Lateral Position,"
Open Journal of Anesthesiology, Vol. 3 No. 3, 2013, pp. 148-151. doi:
10.4236/ojanes.2013.33034.
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