The comparison between bronchial occlusion and artificial pneumothorax for thoracoscopic lobectomy in infants

Abstract Objective To compare the difference between single-lung ventilation with bronchial occlusion and double-lung ventilation with carbon dioxide artificial pneumothorax for thoracoscopic lobectomy in infants. Design This is a retrospective study. Setting It was done in a teaching hospital. Participants Between March 2017 and April 2020, a total of 72 infants underwent thoracoscopic lobectomy in our hospital. Interventions 21 patients received single-lung ventilation with bronchial occlusion, and 51 patients with carbon dioxide(CO2) artificial pneumothorax. Measurements The patient data included the endotracheal intubation length, surgical exposure, intraoperative blood loss, and operation duration. The mean arterial pressure (MAP), central venous pressure (CVP) and peak inspiratory pressure (Ppeak), partial pressure of oxygen in arterial blood(PaO2), and partial pressure of carbon dioxide in arterial blood (PaCO2) were measured at four time points: time of bilateral lung ventilation before the thoracic operation (T0), 10 minutes after the operation started (T1), 30 minutes after the operation started (T2), 60 minutes after the operation started (T3) and 10 minutes after the operation was over (T4). Main Results Compared to artificial pneumothorax, the bronchial occlusion group has the following advantages: the surgical exposure was better, the operation duration was shorter, there was less intraoperative bleeding, and the duration of tracheal intubation was shorter (P 0.05). Conclusion Compared with CO2 artificial pneumothorax, bronchial occlusion is more favourable for thoracoscopic lobectomy in infants.