The impact of various artificial pneumothorax on the quality of surgical exposure in thoracic esophageal laparoscopic surgery

Objective: This study is to explore the impact of different pressure of artificial pneumothorax on surgical exposure and patients’ respiratory and circulation in thoracic esophageal laparoscopic surgery. Method: The 60 esophageal cancer patients were randomly divided into 2 groups: the experiment group (single lumen endotracheal intubation with artificial pneumothorax pressure of 9 mmHg) and the control group (double lumen endotracheal intubation with artificial pneumothorax pressure of 6 mmHg), with 30 cases in each group. With low-speed inflation (2-3 L/min), invasive arterial pressure, heart rate, pulse oximetry, end-tidal CO2 partial pressure, blood PH value, PO2, PCO2, and blood gas analysis was monitored before inflation, 15 min, 30 min, and 45 min of inflation, and 15 min after inflation. Surgical exposures were assessed using surgical exposure quality score sheet. Results: After CO2 inflation, there was no obvious change in invasive blood pressure and pulse oximetry at baseline, while there were significant differences in heart rate, airway pressure, CO2 partial pressure, end tidal CO2 partial pressure, PH value and oxygen partial pressure between the two groups. Fifteen minutes after the inflation, all indicators returned to baseline. The changes of indicators were smaller in experiment group compared with control group. Conclusion: The surgical exposure was better and with less impact on patients’ respiratory and circulation in 9 mmHg single lumen endotracheal intubation group, compared with 6 mmHg double-lumen endotracheal intubation group in thoracoscopic esophageal resection.