Adverse outcomes of artificial pneumothorax under right bronchial occlusion for patients with thoracoscopic-assisted oesophagectomy in the prone position versus the semiprone position
BackgroundThere are few studies on the impact of body position on variations in circulation and breathing, and it has not been confirmed whether body position changes can reduce the pulmonary complications of thoracoscopic-assisted oesophagectomy.MethodsA single-center retrospective study included p...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2022-08-01
|
| Series: | Frontiers in Oncology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2022.919910/full |
| _version_ | 1811342153605971968 |
|---|---|
| author | Qiongzhen Li Mingye Zhao Dongjin Wu Xufeng Guo Jingxiang Wu |
| author_facet | Qiongzhen Li Mingye Zhao Dongjin Wu Xufeng Guo Jingxiang Wu |
| author_sort | Qiongzhen Li |
| collection | DOAJ |
| description | BackgroundThere are few studies on the impact of body position on variations in circulation and breathing, and it has not been confirmed whether body position changes can reduce the pulmonary complications of thoracoscopic-assisted oesophagectomy.MethodsA single-center retrospective study included patients undergoing thoracoscopic-assisted oesophagectomy in the prone position or semiprone position between 1 July 2020, and 30 June 2021, at the Shanghai Chest Hospital. There were 103 patients with thoracoscopic-assisted oesophagectomy in the final analysis, including 43 patients undergoing thoracoscopic-assisted oesophagectomy in the prone position. Postoperative pulmonary complication (PPC) incidence was the primary endpoint. The incidence of cardiovascular and other complications was the secondary endpoint. Chest tube duration, patient-controlled anaesthesia (PCA) pressing frequency within 24 h, ICU stay, and the postoperative hospital length of stay (LOS) were also collected.ResultsCompared with the semiprone position, the prone position decreased the incidence of atelectasis (12% vs. 30%, P = 0.032). Nevertheless, there were no considerable differences in the rates of cardiovascular and other complications, ICU stay, or LOS (P >0.05). Multivariable logistic regression analysis showed that the prone position (OR = 0.196, P = 0.011), no smoking (OR = 0.103, P <0.001), preoperative DLCO% ≥90% (OR = 0.230, P = 0.003), and an operative time <180 min (OR = 0.268, P = 0.006) were associated with less atelectasis.ConclusionsOur study shows that artificial pneumothorax under right bronchial occlusion one-lung ventilation for patients with thoracoscopic-assisted oesophagectomy in the prone position can decrease postoperative atelectasis compared with the semiprone position. |
| first_indexed | 2024-04-13T19:05:20Z |
| format | Article |
| id | doaj.art-eef25846eded43ddb7e2bd516de2fc3f |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-04-13T19:05:20Z |
| publishDate | 2022-08-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-eef25846eded43ddb7e2bd516de2fc3f2022-12-22T02:33:59ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2022-08-011210.3389/fonc.2022.919910919910Adverse outcomes of artificial pneumothorax under right bronchial occlusion for patients with thoracoscopic-assisted oesophagectomy in the prone position versus the semiprone positionQiongzhen Li0Mingye Zhao1Dongjin Wu2Xufeng Guo3Jingxiang Wu4Department of Anesthesiology, Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai, ChinaDepartment of Anesthesiology, Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai, ChinaDepartment of Anesthesiology, Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai, ChinaDepartment of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai, ChinaDepartment of Anesthesiology, Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai, ChinaBackgroundThere are few studies on the impact of body position on variations in circulation and breathing, and it has not been confirmed whether body position changes can reduce the pulmonary complications of thoracoscopic-assisted oesophagectomy.MethodsA single-center retrospective study included patients undergoing thoracoscopic-assisted oesophagectomy in the prone position or semiprone position between 1 July 2020, and 30 June 2021, at the Shanghai Chest Hospital. There were 103 patients with thoracoscopic-assisted oesophagectomy in the final analysis, including 43 patients undergoing thoracoscopic-assisted oesophagectomy in the prone position. Postoperative pulmonary complication (PPC) incidence was the primary endpoint. The incidence of cardiovascular and other complications was the secondary endpoint. Chest tube duration, patient-controlled anaesthesia (PCA) pressing frequency within 24 h, ICU stay, and the postoperative hospital length of stay (LOS) were also collected.ResultsCompared with the semiprone position, the prone position decreased the incidence of atelectasis (12% vs. 30%, P = 0.032). Nevertheless, there were no considerable differences in the rates of cardiovascular and other complications, ICU stay, or LOS (P >0.05). Multivariable logistic regression analysis showed that the prone position (OR = 0.196, P = 0.011), no smoking (OR = 0.103, P <0.001), preoperative DLCO% ≥90% (OR = 0.230, P = 0.003), and an operative time <180 min (OR = 0.268, P = 0.006) were associated with less atelectasis.ConclusionsOur study shows that artificial pneumothorax under right bronchial occlusion one-lung ventilation for patients with thoracoscopic-assisted oesophagectomy in the prone position can decrease postoperative atelectasis compared with the semiprone position.https://www.frontiersin.org/articles/10.3389/fonc.2022.919910/fulloesophagectomythoracoscopyartificial pneumothoraxone-lung ventilation (OLV)prone positionsemiprone position |
| spellingShingle | Qiongzhen Li Mingye Zhao Dongjin Wu Xufeng Guo Jingxiang Wu Adverse outcomes of artificial pneumothorax under right bronchial occlusion for patients with thoracoscopic-assisted oesophagectomy in the prone position versus the semiprone position Frontiers in Oncology oesophagectomy thoracoscopy artificial pneumothorax one-lung ventilation (OLV) prone position semiprone position |
| title | Adverse outcomes of artificial pneumothorax under right bronchial occlusion for patients with thoracoscopic-assisted oesophagectomy in the prone position versus the semiprone position |
| title_full | Adverse outcomes of artificial pneumothorax under right bronchial occlusion for patients with thoracoscopic-assisted oesophagectomy in the prone position versus the semiprone position |
| title_fullStr | Adverse outcomes of artificial pneumothorax under right bronchial occlusion for patients with thoracoscopic-assisted oesophagectomy in the prone position versus the semiprone position |
| title_full_unstemmed | Adverse outcomes of artificial pneumothorax under right bronchial occlusion for patients with thoracoscopic-assisted oesophagectomy in the prone position versus the semiprone position |
| title_short | Adverse outcomes of artificial pneumothorax under right bronchial occlusion for patients with thoracoscopic-assisted oesophagectomy in the prone position versus the semiprone position |
| title_sort | adverse outcomes of artificial pneumothorax under right bronchial occlusion for patients with thoracoscopic assisted oesophagectomy in the prone position versus the semiprone position |
| topic | oesophagectomy thoracoscopy artificial pneumothorax one-lung ventilation (OLV) prone position semiprone position |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2022.919910/full |
| work_keys_str_mv | AT qiongzhenli adverseoutcomesofartificialpneumothoraxunderrightbronchialocclusionforpatientswiththoracoscopicassistedoesophagectomyinthepronepositionversusthesemiproneposition AT mingyezhao adverseoutcomesofartificialpneumothoraxunderrightbronchialocclusionforpatientswiththoracoscopicassistedoesophagectomyinthepronepositionversusthesemiproneposition AT dongjinwu adverseoutcomesofartificialpneumothoraxunderrightbronchialocclusionforpatientswiththoracoscopicassistedoesophagectomyinthepronepositionversusthesemiproneposition AT xufengguo adverseoutcomesofartificialpneumothoraxunderrightbronchialocclusionforpatientswiththoracoscopicassistedoesophagectomyinthepronepositionversusthesemiproneposition AT jingxiangwu adverseoutcomesofartificialpneumothoraxunderrightbronchialocclusionforpatientswiththoracoscopicassistedoesophagectomyinthepronepositionversusthesemiproneposition |