Study on the Safety of Different Pressure Artificial Pneumothorax on Endoscopic Radical Esophagectomy

Abstract

Objective: To study the effect of different pressure artificial pneumothorax on total endoscopic radical esophagectomy during and after an operation. Methods: From 2019 to 2021, 64 patients with esophageal cancer underwent video-assisted thoracoscopic surgery in the same surgical treatment group. The pressure of CO 2 artificial pneumothorax was randomly divided into Group A (pressure 6 mmHg), Group B (pressure 8 mmHg) , and Group C (pressure 10 mmHg). Heart rate (HR), mean arterial pressure (MAP), end-expiratory CO 2 partial pressure (PETCO 2 ), arterial blood pH and PaCO 2 , operation time, intraoperative blood loss , and anesthesia resuscitation time were recorded at different time points. Observe the changes in inflammatory indexes, coagulation function , and the incidence of complications in the three groups, and statistically analyze and compare the differences among the three groups of patients. Results: Sixty-four patients with esophageal cancer were included in this clinical study. There were no significant differences in gender, age, lung function, BMI , and coagulation function among the three groups (P > 0.05). There were significant differences in PETCO 2 , arterial pH , and PaCO 2 in T2, T3 , and T4 among the three groups (P < 0.05). The arterial blood gas index at T5 in Group A was significantly different from that in Group C (P < 0.05). The time of thoracic operation in Group A was significantly longer than that in the other two groups (P < 0.05), and the time of tracheal intubation and extubation was earlier in Group A (P < 0.05). The incidence of subcutaneous emphysema, thoracic tube time , and prothrombin time in Group A was significantly different from those in Group B and C (P < 0.05). There were no significant differences in hospitalization days, pulmonary infection , and other complications (P > 0.05). Conclusion: The artificial pneumothorax with 6 mmHg pressure and 8 L/min flow rate can satisfy the operation, and its safety and postoperative recovery are also better.