초록접수 현황
| 16F-145 | 구연 발표 |
Feasibility of Minimally Invasive Cardiac Surgery without One Lung Ventilation
Hyung Gon Je, Jong Myung Park, Mi Hee Lim, Sang Kwon Lee
Department of Thoracic and Cardiovascular Surgery, Pusan National University Yangsan Hospital, Pusan National University College of Medicine, Gyeongsangnam-do, Korea
Background : Minimally invasive cardiac surgery (MICS) has been more widely adopted to facilitate early recovery. For the right anterior thoracotomy approach, the one-lung ventilation (OLV) using double-lumen tube (DLT) is required but complication related to DLT is not negligible. Therefore we investigated the feasibility and efficacy of single-lumen endotracheal tube (SLT) during MICS.
Methods : We conducted a retrospective review of clinical data of 370 patients who underwent MICS via thoracotomy between August 2009 and March 2016. Patients using SLT (n=167) were compare with DLT (n=203). In SLT group, exposure of pleural and pericardial space was assisted with intermittent lung deflation and low tidal / high frequency ventilation.
Results : The preoperative variables were comparable between groups except age (SLT: 56.1 ± 15.1 vs. DLT: 51.2 ± 16.4, P=0.003), emergency (SLT: 12 (7.2%) vs. DLT: 4 (2.0%), P=0.019), and NYHA class IV (SLT: 32 (19.2%) vs. DLT: 20 (9.9%), P=0.01). There was no difference in postoperative results except duration of mechanical ventilation, and the rate of extubation in the operation room. (Table 1)
Conclusion : Comparing with insertion of a DLT, MICS with SLT provided equivalent clinical results with shorter mechanical ventilation time. MICS procedures with SLT appear to be a feasible alternative to OLV with DLT and may facilitate faster recovery.
Methods : We conducted a retrospective review of clinical data of 370 patients who underwent MICS via thoracotomy between August 2009 and March 2016. Patients using SLT (n=167) were compare with DLT (n=203). In SLT group, exposure of pleural and pericardial space was assisted with intermittent lung deflation and low tidal / high frequency ventilation.
Results : The preoperative variables were comparable between groups except age (SLT: 56.1 ± 15.1 vs. DLT: 51.2 ± 16.4, P=0.003), emergency (SLT: 12 (7.2%) vs. DLT: 4 (2.0%), P=0.019), and NYHA class IV (SLT: 32 (19.2%) vs. DLT: 20 (9.9%), P=0.01). There was no difference in postoperative results except duration of mechanical ventilation, and the rate of extubation in the operation room. (Table 1)
Conclusion : Comparing with insertion of a DLT, MICS with SLT provided equivalent clinical results with shorter mechanical ventilation time. MICS procedures with SLT appear to be a feasible alternative to OLV with DLT and may facilitate faster recovery.
책임저자: Hyung Gon Je
Department of Thoracic and Cardiovascular Surgery, Pusan National University Yangsan Hospital, Pusan National University College of Medicine, Gyeongsangnam-do, Korea
발표자: Hyung Gon Je, E-mail : jehg7332@gmail.com