Clinical analysis of the mediastinal tumor in patients with spontaneous breathing intravenous anesthesia_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

HE Kaiming , DAI Tianyang , ZENG Peiyuan , PU Jiangtao

Department of Cardiothoracic Surgery, Affiliated Hospital of Southwest Medical University, Luzhou, 646000, Sichuan, P.R.China;

Corresponding author：

Keywords：

Spontaneous intravenous anesthesia; thoracoscope; mediastinal tumor

DOI：

10.7507/1007-4848.201712005

Video：

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Objective To evaluate the safety and the clinical curative effect of mediastinal tumor resection by video-assisted thoracoscopic surgery(VATS） with spontaneous breathing under intravenous anesthesia, comparing with endotracheal tube anesthesia.Methods The data of 43 patients, aged 28–58 years, with mediastinal benign tumors which had been cofirmed by chest CT in our hospital were retrospectively analyzed. Among them, 18 patients underwent mediastinal tumor resection by VATS with spontaneous breathing under intravenous anesthesia, 25 patients by endotracheal tube anesthesia.The differences, including the time of anesthesia intubation and extubation, operation time and intraoperative blood loss, muscle strength at 4 hours and at 24 hours after operation, pain score at 24 hours after operation, hospitalization time, were be compared between the two groups.Results The duration of intubation (17.8±4.8 min) in spontaneous breathing under intravenous anesthesia group was shorter than another group (28.6±8.17 min), the difference was statistically significant (P<0.05). Muscle strength at 4 hours after operation in spontaneous breathing under intravenous anesthesia group was significantly higher than another group (38.5±6.5 kg vs. 28.3±5.2 kg, P<0.05) as well. However, there was no significant difference between the two groups in extubation time, operation time and intraoperative blood loss, muscle strength and pain score at 24 hours after operation, hospitalization time.

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8.	王索宇, 徐仁根. 纵隔肿瘤及肿瘤样病变的 CT 诊断. 肿瘤研究与临床, 2006, 18(3): 169-170, 176.
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14.	张晓峰, 张其刚. 185 例胸腺瘤的临床特点. 中国胸心血管外科临床杂志, 2007, 14(2): 108-111.
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16.	郑晖, 段勇, 耿万明, 等. 不同支气管导管及支气管阻塞导管在开胸单肺通气患者中的应用. 中华医学杂志, 2012, 92(35): 2481-2484.
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1. Kalabukha IA; Mayetniy EM. Benign tumors of mediastinum: clinic, diagnosis, surgical treatment. Klin Khir, 2016, 12: 33-35.
2. Fraga JC, Aydogdu B, Aufieri R, et al. Surgical treatment for pediatric mediastinal neurogenic tumors. Ann Thorac Surg, 2010, 90(2): 413-418.
3. Tanaka T, Ueda K, Hayashi M, et al. Totally thoracoscopic resection of a superior mediastinal tumor extending above the thoracic inlet. J Thorac Cardiovasc Surg, 2011, 141(5): 1323-1325.
4. Lin F, Pu Q, Ma L, et al. Surgical treatment of primary mediastinal myelolipoma. Interact Cardiovasc Thorac Surg, 2015, 21(2): 206-210.
5. Cansever L, Kocaturk CI, Cinar HU, et al. Benign posterior mediastinal neurogenic tumors: results of a comparative study into video-assisted thoracic surgery and thoracotomy (13 years’ experience). Thorac Cardiovasc Surg, 2010, 58(8): 473-475.
6. Montes FR, Pardo DF, Charrís H, et al. Comparison of two protective lung ventilatory regimes on oxygenation during one-lung ventilation: a randomized controlled trial. J Cardiothorac Surg, 2010, 5: 99.
7. Lee P, Mathur PN, Colt HG. Advances in thoracoscopy: 100 years since Jacobaeus. Respiration, 2010, 79(3): 177-186.
8. 王索宇, 徐仁根. 纵隔肿瘤及肿瘤样病变的 CT 诊断. 肿瘤研究与临床, 2006, 18(3): 169-170, 176.
9. Hung MH, Hsu HH, Chen KC, et al. Nonintubated thoracoscopic anatomical segmentectomy for lung tumors. Ann Thorac Surg, 2013, 96(4): 1209-1215.
10. Wu CY, Chen JS, Lin YS, et al. Feasibility and safety of nonintubated thoracoscopic lobectomy for geriatric lung cancer patients. Ann Thorac Surg, 2013, 95(2): 405-411.
11. Tsai TM, Chen JS. Nonintubated thoracoscopic surgery for pulmonary lesions in both lungs. J Thorac Cardiovasc Surg, 2012, 144(3): e95-e97.
12. 代小探, 宋平平, 张百江. 非气管插管在胸外科 VATS 中的应用. 中国肺癌杂志, 2016, 19(5): 312-316.
13. Ambrogi MC, Fanucchi O, Korasidis S, et al. Nonintubated thoracoscopic pulmonary nodule resection under spontaneous breathing anesthesia with laryngeal mask. Innovations (Phila), 2014, 9(4): 276-280.
14. 张晓峰, 张其刚. 185 例胸腺瘤的临床特点. 中国胸心血管外科临床杂志, 2007, 14(2): 108-111.
15. Pacheco-Lopez PC, Berkow LC, Hillel AT, et al. Complications of airway management. Respir Care, 2014, 59(6): 1006-1019.
16. 郑晖, 段勇, 耿万明, 等. 不同支气管导管及支气管阻塞导管在开胸单肺通气患者中的应用. 中华医学杂志, 2012, 92(35): 2481-2484.
17. Wasem S, Lazarus M, Hain J, et al. Comparison of the Airtraq and the Macintosh laryngoscope for double-lumen tube intubation: a randomised clinical trial. Eur J Anaesthesiol, 2013, 30(4): 180-186.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

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