%0 Journal Article %T CO 2 during single incisional thoracoscopic bleb resection with two-lung ventilation %A Lee, Dong Kyu %A Kim, Heezoo %A Kim, Hyun Koo %A Chung, Dong Ik %A Han, Kook Nam %A Choi, Young Ho %J Journal of Thoracic Disease %D 2018 %B 2018 %9 %! CO 2 during single incisional thoracoscopic bleb resection with two-lung ventilation %K %X Background: CO 2 insufflation could provide a better surgical field during single-incision thoracoscopic surgery (SITS) with small tidal two-lung ventilation (ST-TLV). Here we compared the surgical field and physiological effects of ST-TLV with and without CO 2 during SITS. Methods: Patients underwent scheduled SITS bullectomy. Surgery under ST-TLV general anesthesia performed without CO 2 (group NC) or with CO 2 insufflation (group C). The surgical field was graded at thoracoscope introduction and at bulla resection as follows: good (more than half of the 1st rib visible; bleb easily grasped with the stapler), fair (less than half of the 1st rib visible; some manipulation needed to grasp the bleb with the stapler), or poor (1st rib non-visible; bleb ungraspable). Vital signs, arterial blood gas analysis (ABGA), and mechanical ventilation parameters, postoperative chest tube indwelling duration, length of hospital stays, and complications were recorded. Results: A total of 80 patients were ultimately included. The surgical field at thoracoscope introduction was better in group C (P=0.022). However, at bleb resection, the surgical fields did not differ (P=0.172). The operation time was significantly longer in group C (P=0.019) and anesthesia recovery time was not different (P=0.369). During the CO 2 insufflation, the airway pressure was higher in group C (P=0.009). Mean PaCO 2 was significantly higher (P=0.012) and mean PaO 2 was significantly lower (P=0.024) in group C, but both values were within the physiologically normal range. Postoperative chest tube indwelling duration and length of hospital stays were not statistically different (P=0.234 and 0.085 respectively). Postoperative complication frequencies were similar (12.5% for group NC, 10.0% for group C, P=0.723). Conclusions: SITS with CO 2 insufflation during ST-TLV did not produce a superior surgical field except at the beginning of surgery. CO 2 insufflation required more time and resulted in higher mean PaCO 2 and peak airway pressure. %U https://jtd.amegroups.org/article/view/23093 %V 10 %N 8 %P 5057-5065 %@ 2077-6624