{"title":"A Comparison of Arterial Blood Gas Data Between Open Esophagectomy and Thoracoscopic Esophagectomy.","authors":"Mariko Akimoto, Daizoh Satoh, Izumi Kawagoe, Yuri Ooizumi-Goto, Chieko Mitaka, Takashi Hashimoto, Masakazu Hayashida","doi":"10.14789/ejmj.JMJ24-0038-OA","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>Minimally invasive thoracoscopic esophagectomy may result in superior post-operative outcomes compared to open esophagectomy. We compared arterial blood gas data during one-lung ventilation (OLV) between thoracoscopic esophagectomy and open esophagectomy.</p><p><strong>Design: </strong>37 patients undergoing thoracoscopic esophagectomy (Group E) and 38 patients undergoing open esophagectomy (Group O) were investigated.</p><p><strong>Methods: </strong>Arterial blood gas was analysed during two-lung ventilation (TLV) immediately before surgery (T1), during OLV for thoracic procedures (T2), during TLV for abdominal procedures (T3) and during spontaneous breathing immediately before extubation (T4).</p><p><strong>Results: </strong>Respiratory function data did not differ between the groups, even though the patients were older (<i>p</i> < 0.05) and the operative time was longer (<i>p</i> < 0.01) in Group E than in Group O. At T2, PaO<sub>2</sub>/F<sub>I</sub>O<sub>2</sub> was lower (<i>p</i> < 0.01) and PaCO<sub>2</sub> was higher (<i>p</i> < 0.01) in Group E than in Group O, although these variables did not differ between groups at T1 or T4. Post operative data showed shorter ICU (<i>p</i> < 0.01) and hospital stay (<i>p</i> < 0.05) in Group E than in Group O but showed no significant difference in the presence of complications.</p><p><strong>Conclusions: </strong>PaO<sub>2</sub>/F<sub>I</sub>O<sub>2</sub> decreased and PaCO<sub>2</sub> increased during OLV for thoracoscopic esophagectomy compared to open esophagectomy. Although thoracoscopic esophagectomy was inferior to open esophagectomy regarding gas exchange during OLV, patients in Group E required less ICU stay and less hospital stay than patients in Group O. The benefits of minimally invasive thoracoscopic esophagectomy may outweigh disadvantages regarding gas exchange during the surgery.</p>","PeriodicalId":520470,"journal":{"name":"Juntendo medical journal","volume":"71 3","pages":"180-186"},"PeriodicalIF":0.0000,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12257221/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Juntendo medical journal","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.14789/ejmj.JMJ24-0038-OA","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"","JCRName":"","Score":null,"Total":0}
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Abstract
Objectives: Minimally invasive thoracoscopic esophagectomy may result in superior post-operative outcomes compared to open esophagectomy. We compared arterial blood gas data during one-lung ventilation (OLV) between thoracoscopic esophagectomy and open esophagectomy.
Design: 37 patients undergoing thoracoscopic esophagectomy (Group E) and 38 patients undergoing open esophagectomy (Group O) were investigated.
Methods: Arterial blood gas was analysed during two-lung ventilation (TLV) immediately before surgery (T1), during OLV for thoracic procedures (T2), during TLV for abdominal procedures (T3) and during spontaneous breathing immediately before extubation (T4).
Results: Respiratory function data did not differ between the groups, even though the patients were older (p < 0.05) and the operative time was longer (p < 0.01) in Group E than in Group O. At T2, PaO2/FIO2 was lower (p < 0.01) and PaCO2 was higher (p < 0.01) in Group E than in Group O, although these variables did not differ between groups at T1 or T4. Post operative data showed shorter ICU (p < 0.01) and hospital stay (p < 0.05) in Group E than in Group O but showed no significant difference in the presence of complications.
Conclusions: PaO2/FIO2 decreased and PaCO2 increased during OLV for thoracoscopic esophagectomy compared to open esophagectomy. Although thoracoscopic esophagectomy was inferior to open esophagectomy regarding gas exchange during OLV, patients in Group E required less ICU stay and less hospital stay than patients in Group O. The benefits of minimally invasive thoracoscopic esophagectomy may outweigh disadvantages regarding gas exchange during the surgery.
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