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Single-port thoracoscopic surgery for pneumothorax under two-lung ventilation with carbon dioxide insufflation

  
@article{JTD7345,
	author = {Kook Nam Han and Hyun Koo Kim and Hyun Joo Lee and Dong Kyu Lee and Heezoo Kim and Sang Ho Lim and Young Ho Choi},
	title = {Single-port thoracoscopic surgery for pneumothorax under two-lung ventilation with carbon dioxide insufflation},
	journal = {Journal of Thoracic Disease},
	volume = {8},
	number = {6},
	year = {2016},
	keywords = {},
	abstract = {Background: The development of single-port thoracoscopic surgery and two-lung ventilation reduced the invasiveness of minor thoracic surgery. This study aimed to evaluate the feasibility and safety of single-port thoracoscopic bleb resection for primary spontaneous pneumothorax using two-lung ventilation with carbon dioxide insufflation.
Methods: Between February 2009 and May 2014, 130 patients underwent single-port thoracoscopic bleb resection under two-lung ventilation with carbon dioxide insufflation. Access was gained using a commercial multiple-access single port through a 2.5-cm incision; carbon dioxide gas was insufflated through a port channel. A 5-mm thoracoscope, articulating endoscopic devices, and flexible endoscopic staplers were introduced through a multiple-access single port for bulla resection. 
Results: The mean time from endotracheal intubation to incision was 29.2±7.8 minutes, the mean operative time was 30.9±8.2 minutes, and the mean total anesthetic time was 75.5±14.4 minutes. There were no anesthesia-related complications or wound problems. The chest drain was removed after a mean of 3.7±1.4 days and patients were discharged without complications 4.8±1.5 days from the operative day. During a mean 7.5±10.1 months of follow-up, there were five recurrences (3.8%) in operated thorax.
Conclusions: The anesthetic strategy of single-lumen intubation with carbon dioxide gas insufflation can be a safe and feasible option for single-port thoracoscopic bulla resection as it represents the least invasive surgical option with the potential advantages of reducing operative time and one-lung ventilation-related complications without diminishing surgical outcomes.},
	issn = {2077-6624},	url = {https://jtd.amegroups.org/article/view/7345}
}