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Efficacy and hemodynamic response of pleural carbon dioxide insufflation during thoracoscopic surgery in a swine vessel injury model.
Surg Today. 2016 Dec; 46(12):1464-1470.ST

Abstract

PURPOSES

Thoracoscopic anatomical lung resection is a minimally invasive technique, but intraoperative massive bleeding is a critical complication. We investigated the hemostatic efficacy and safety of intrapleural carbon dioxide (CO2) insufflation in thoracoscopic surgery in a swine vessel injury model.

METHODS

Swines were assigned to one of four groups subjected to thoracoscopic surgery under target intrathoracic pressures of 0, 5, 10, or 15 mmHg CO2 insufflation, respectively. A pin-hole injury of the right cranial lobe pulmonary vein was inflicted thoracoscopically and we compared the blood loss and hemodynamic changes in each group.

RESULTS

There were no signs or echographic findings of air embolus. Both the blood loss per minute and total blood loss during the experiment were significantly lower in the 10 and 15 mmHg groups than in the 0 mmHg group (p > 0.05, respectively). The hemodynamic signs, including heart rate, mean arterial pressure, and peripheral oxygen saturation, were not significantly different in the 0 and 10 mmHg groups at most times, although they were significantly correlated with the insufflation pressure during the experiments (p < 0.05).

CONCLUSIONS

CO2 insufflation in thoracoscopic major lung resection appears to be safe, even in the short term, and can help to control vessel injury.

Authors+Show Affiliations

Department of General Thoracic Surgery, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi, Tokyo, 173-8606, Japan.Department of General Thoracic Surgery, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi, Tokyo, 173-8606, Japan. yusuketakahashigts@gmail.com.Department of General Thoracic Surgery, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi, Tokyo, 173-8606, Japan.Department of General Thoracic Surgery, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi, Tokyo, 173-8606, Japan.Department of General Thoracic Surgery, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi, Tokyo, 173-8606, Japan.Department of General Thoracic Surgery, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi, Tokyo, 173-8606, Japan.Department of General Thoracic Surgery, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi, Tokyo, 173-8606, Japan.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

26988853

Citation

Okamura, Ryo, et al. "Efficacy and Hemodynamic Response of Pleural Carbon Dioxide Insufflation During Thoracoscopic Surgery in a Swine Vessel Injury Model." Surgery Today, vol. 46, no. 12, 2016, pp. 1464-1470.
Okamura R, Takahashi Y, Dejima H, et al. Efficacy and hemodynamic response of pleural carbon dioxide insufflation during thoracoscopic surgery in a swine vessel injury model. Surg Today. 2016;46(12):1464-1470.
Okamura, R., Takahashi, Y., Dejima, H., Nakayama, T., Uehara, H., Matsutani, N., & Kawamura, M. (2016). Efficacy and hemodynamic response of pleural carbon dioxide insufflation during thoracoscopic surgery in a swine vessel injury model. Surgery Today, 46(12), 1464-1470.
Okamura R, et al. Efficacy and Hemodynamic Response of Pleural Carbon Dioxide Insufflation During Thoracoscopic Surgery in a Swine Vessel Injury Model. Surg Today. 2016;46(12):1464-1470. PubMed PMID: 26988853.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Efficacy and hemodynamic response of pleural carbon dioxide insufflation during thoracoscopic surgery in a swine vessel injury model. AU - Okamura,Ryo, AU - Takahashi,Yusuke, AU - Dejima,Hitoshi, AU - Nakayama,Takashi, AU - Uehara,Hirofumi, AU - Matsutani,Noriyuki, AU - Kawamura,Masafumi, Y1 - 2016/03/17/ PY - 2015/11/04/received PY - 2016/02/16/accepted PY - 2016/11/4/pubmed PY - 2017/3/9/medline PY - 2016/3/19/entrez KW - Animal model KW - Bleeding control KW - Endoscopic procedure KW - Pulmonary vein KW - VATS SP - 1464 EP - 1470 JF - Surgery today JO - Surg. Today VL - 46 IS - 12 N2 - PURPOSES: Thoracoscopic anatomical lung resection is a minimally invasive technique, but intraoperative massive bleeding is a critical complication. We investigated the hemostatic efficacy and safety of intrapleural carbon dioxide (CO2) insufflation in thoracoscopic surgery in a swine vessel injury model. METHODS: Swines were assigned to one of four groups subjected to thoracoscopic surgery under target intrathoracic pressures of 0, 5, 10, or 15 mmHg CO2 insufflation, respectively. A pin-hole injury of the right cranial lobe pulmonary vein was inflicted thoracoscopically and we compared the blood loss and hemodynamic changes in each group. RESULTS: There were no signs or echographic findings of air embolus. Both the blood loss per minute and total blood loss during the experiment were significantly lower in the 10 and 15 mmHg groups than in the 0 mmHg group (p > 0.05, respectively). The hemodynamic signs, including heart rate, mean arterial pressure, and peripheral oxygen saturation, were not significantly different in the 0 and 10 mmHg groups at most times, although they were significantly correlated with the insufflation pressure during the experiments (p < 0.05). CONCLUSIONS: CO2 insufflation in thoracoscopic major lung resection appears to be safe, even in the short term, and can help to control vessel injury. SN - 1436-2813 UR - https://www.unboundmedicine.com/medline/citation/26988853/Efficacy_and_hemodynamic_response_of_pleural_carbon_dioxide_insufflation_during_thoracoscopic_surgery_in_a_swine_vessel_injury_model_ L2 - https://dx.doi.org/10.1007/s00595-016-1323-7 DB - PRIME DP - Unbound Medicine ER -