Skip to main content
Top
Published in: Surgical Endoscopy 7/2016

01-07-2016

Impact of artificial capnothorax on coagulation in patients during video-assisted thoracoscopic esophagectomy for squamous cell carcinoma

Authors: Qing-Xiang Mao, Wei Guo, Bing-Qiang Huang, Hong Yan

Published in: Surgical Endoscopy | Issue 7/2016

Login to get access

Abstract

Background

Compared with the lung isolation using double-lumen endobronchial tube intubation, the artificial capnothorax using single-lumen endotracheal tube intubation has shown to be a safe, more convenient, and cost-effective procedure for thoracoscopic esophagectomy. However, the impact of capnothorax on coagulation is not well defined. Herein, we evaluate the impact of a capnothorax on coagulation and fibrinolysis in patients who undergoing thoracoscopic esophagectomy.

Methods

Between March 2014 and August 2014, 24 patients underwent thoracoscopic esophagectomies for esophageal cancer with the procedure of artificial capnothorax (group P); we also performed 24 thoracoscopic esophagectomy cases without using capnothorax (group N). The demographics and arterial blood gas, as well as the parameters of coagulation and fibrinolysis, of the two groups were analyzed.

Results

The pH value of group P after CO2 insufflation was significantly lower than in group N (P < 0.05), and the partial pressure of carbon dioxide (PaCO2) was significantly increased compared with group N (P < 0.05). The R and K values after CO2 insufflation were significantly longer than before anesthesia (P < 0.05), and both α angle and MA value after CO2 insufflation were significantly lower than those before anesthesia (P < 0.05). No significant differences in R value, K value, α angle, or MA value were observed between pre-anesthesia and termination of capnothorax. No significant difference in LY30 data was found between different groups (P > 0.05).

Conclusion

Artificial capnothorax in patients receiving endoscopic resection of esophageal carcinoma had a significant impact on coagulation. These patients showed significant impairments in coagulation not observed in patients without artificial capnothorax.
Literature
1.
go back to reference Luketich JD, Schauer PR, Christie NA, Weigel TL, Raja S, Fernando HC, Keenan RJ, Nguyen NT (2000) Minimally invasive esophagectomy. Ann Thorac Surg 70:906–912CrossRefPubMed Luketich JD, Schauer PR, Christie NA, Weigel TL, Raja S, Fernando HC, Keenan RJ, Nguyen NT (2000) Minimally invasive esophagectomy. Ann Thorac Surg 70:906–912CrossRefPubMed
3.
go back to reference Gao Y, Wang Y, Chen L, Zhao Y (2011) Comparison of open three-field and minimally-invasive esophagectomy for esophageal cancer. Interact CardioVasc Thorac Surg 12:366–369CrossRefPubMed Gao Y, Wang Y, Chen L, Zhao Y (2011) Comparison of open three-field and minimally-invasive esophagectomy for esophageal cancer. Interact CardioVasc Thorac Surg 12:366–369CrossRefPubMed
4.
go back to reference Wang H, Tan L, Feng M, Zhang Y, Wang Q (2011) Comparison of the short-term healthrelated quality of life in patients with esophageal cancer with different routes of gastric tube reconstruction after minimally invasive esophagectomy. Qual Life Res 20:179–189CrossRefPubMed Wang H, Tan L, Feng M, Zhang Y, Wang Q (2011) Comparison of the short-term healthrelated quality of life in patients with esophageal cancer with different routes of gastric tube reconstruction after minimally invasive esophagectomy. Qual Life Res 20:179–189CrossRefPubMed
5.
go back to reference El-Dawlatly AA, Al Kattan K, Hajjar W, Essa M, Delvi B, Khoja A (2005) Anesthetic implications for video assisted thoracoscopic thymectomy in myasthenia gravis. Middle East J Anesthesiol 18:339–345PubMed El-Dawlatly AA, Al Kattan K, Hajjar W, Essa M, Delvi B, Khoja A (2005) Anesthetic implications for video assisted thoracoscopic thymectomy in myasthenia gravis. Middle East J Anesthesiol 18:339–345PubMed
6.
go back to reference Baraka A, Leteif A (2001) One-lung ventilation during video-assisted thoracoscopy. Middle East J Anesthesiol 16:119–126PubMed Baraka A, Leteif A (2001) One-lung ventilation during video-assisted thoracoscopy. Middle East J Anesthesiol 16:119–126PubMed
7.
go back to reference Wolfer RS, Krasna MJ, Hasnain JU, McLaughlin JS (1994) Hemodynamic effects of carbon dioxide insufflation during thoracoscopy. Ann Thorac Surg 58:404–408CrossRefPubMed Wolfer RS, Krasna MJ, Hasnain JU, McLaughlin JS (1994) Hemodynamic effects of carbon dioxide insufflation during thoracoscopy. Ann Thorac Surg 58:404–408CrossRefPubMed
8.
go back to reference Larsen JF, Ejstrud P, Svendsen F, Redke F, Pedersen V, Rahr HB (2001) Randomized study of coagulation and fibrinolysis during and after gasless and conventional laparoscopic cholecystectomy. Br J Surg 88:1001–1105CrossRefPubMed Larsen JF, Ejstrud P, Svendsen F, Redke F, Pedersen V, Rahr HB (2001) Randomized study of coagulation and fibrinolysis during and after gasless and conventional laparoscopic cholecystectomy. Br J Surg 88:1001–1105CrossRefPubMed
9.
go back to reference Schietroma M, Carlei F, Mownah A, Franchi L, Mazzotta C, Sozio A, Amicucci G (2004) Changes in the blood coagulation, fibrinolysis, and cytokine profile during laparoscopic and open cholecystectomy. Surg Endosc 18:1090–1096CrossRefPubMed Schietroma M, Carlei F, Mownah A, Franchi L, Mazzotta C, Sozio A, Amicucci G (2004) Changes in the blood coagulation, fibrinolysis, and cytokine profile during laparoscopic and open cholecystectomy. Surg Endosc 18:1090–1096CrossRefPubMed
10.
go back to reference Nguyen NT, Owings JT, Gosselin R, Pevec WC, Lee SJ, Goldman C, Wolfe BM (2001) Systemic coagulation and fibrinolysis after laparoscopic and open gastric bypass. Arch Surg 136:909–916CrossRefPubMed Nguyen NT, Owings JT, Gosselin R, Pevec WC, Lee SJ, Goldman C, Wolfe BM (2001) Systemic coagulation and fibrinolysis after laparoscopic and open gastric bypass. Arch Surg 136:909–916CrossRefPubMed
11.
go back to reference Dorn GW (2009) Novel pharmacotherapies to abrogate postinfarction ventricular remodeling. Nat Rev Cardiol 6:283–291CrossRefPubMed Dorn GW (2009) Novel pharmacotherapies to abrogate postinfarction ventricular remodeling. Nat Rev Cardiol 6:283–291CrossRefPubMed
12.
go back to reference Mias C, Lairez O, Trouche E, Roncalli J, Calise D, Seguelas MH, Ordener C, Piercecchi-Marti MD, Auge N, Salvayre AN, Bourin P, Parini A, Cussac D (2009) Mesenchymal stem cells promote matrix metalloproteinase secretion by cardiac fibroblasts and reduce cardiac ventricular fibrosis after myocardial infarction. Stem Cells 27:2734–2743CrossRefPubMed Mias C, Lairez O, Trouche E, Roncalli J, Calise D, Seguelas MH, Ordener C, Piercecchi-Marti MD, Auge N, Salvayre AN, Bourin P, Parini A, Cussac D (2009) Mesenchymal stem cells promote matrix metalloproteinase secretion by cardiac fibroblasts and reduce cardiac ventricular fibrosis after myocardial infarction. Stem Cells 27:2734–2743CrossRefPubMed
13.
go back to reference Nie R, Xie S, Du B, Liu X, Deng B, Wang J (2009) Extracellular matrix metalloproteinase inducer (EMMPRIN) is increased in human left ventricle after acute myocardial infarction. Arch Med Res 40:605–611CrossRefPubMed Nie R, Xie S, Du B, Liu X, Deng B, Wang J (2009) Extracellular matrix metalloproteinase inducer (EMMPRIN) is increased in human left ventricle after acute myocardial infarction. Arch Med Res 40:605–611CrossRefPubMed
14.
go back to reference Etoh T, Joffs C, Deschamps AM, Davis J, Dowdy K, Hendrick J, Baicu S, Mukherjee R, Manhaini M, Spinale FG (2001) Myocardial and interstitial matrix metalloproteinase activity after acute myocardial infarction in pigs. Am J Physiol Heart Circ Physiol 281:H987–H994PubMed Etoh T, Joffs C, Deschamps AM, Davis J, Dowdy K, Hendrick J, Baicu S, Mukherjee R, Manhaini M, Spinale FG (2001) Myocardial and interstitial matrix metalloproteinase activity after acute myocardial infarction in pigs. Am J Physiol Heart Circ Physiol 281:H987–H994PubMed
15.
go back to reference Ohtsuka T, Imanaka K, Endoh M, Kohno T, Nakajima J, Kotsuka Y, Takamoto S (1999) Hemodynamic effects of carbon dioxide insufflation under single-lung ventilation during thoracoscopy. Ann Thorac Surg 68:29–33CrossRefPubMed Ohtsuka T, Imanaka K, Endoh M, Kohno T, Nakajima J, Kotsuka Y, Takamoto S (1999) Hemodynamic effects of carbon dioxide insufflation under single-lung ventilation during thoracoscopy. Ann Thorac Surg 68:29–33CrossRefPubMed
16.
go back to reference Byhahn C, Mierdl S, Meininger D, Wimmer-Greinecker G, Matheis G, Westphal K (2001) Hemodynamics and gas exchange during carbon dioxide insufflation for totally endoscopic coronary artery bypass grafting. Ann Thorac Surg 71:1496–1502CrossRefPubMed Byhahn C, Mierdl S, Meininger D, Wimmer-Greinecker G, Matheis G, Westphal K (2001) Hemodynamics and gas exchange during carbon dioxide insufflation for totally endoscopic coronary artery bypass grafting. Ann Thorac Surg 71:1496–1502CrossRefPubMed
17.
go back to reference Tran DT, Badner NH, Nicolaou G, Sischek W (2010) Arterial PCO2 changes during thoracoscopic surgery with CO2 insufflation and one lung ventilation. HSR Proc Intensive Care Cardiovasc Anesth 2:191–197PubMedPubMedCentral Tran DT, Badner NH, Nicolaou G, Sischek W (2010) Arterial PCO2 changes during thoracoscopic surgery with CO2 insufflation and one lung ventilation. HSR Proc Intensive Care Cardiovasc Anesth 2:191–197PubMedPubMedCentral
18.
go back to reference Meng ZH, Wolberg AS, Monroe DM 3rd, Hoffman M (2003) The effect of temperature and pH on the activity of factor VIIa: implications for the efficacy of high dose factor VIIa in hypothermic and acidotic patients. Trauma 55:886–891CrossRef Meng ZH, Wolberg AS, Monroe DM 3rd, Hoffman M (2003) The effect of temperature and pH on the activity of factor VIIa: implications for the efficacy of high dose factor VIIa in hypothermic and acidotic patients. Trauma 55:886–891CrossRef
19.
go back to reference Martini WZ, Pusateri AE, Uscilowicz JM, Delgado AV, Holcomb JB (2005) Independent contributions of hypothermia and acidosis to coagulopathy in swine. Trauma 58:1002–1010CrossRef Martini WZ, Pusateri AE, Uscilowicz JM, Delgado AV, Holcomb JB (2005) Independent contributions of hypothermia and acidosis to coagulopathy in swine. Trauma 58:1002–1010CrossRef
20.
21.
go back to reference Kashuk JL, Moore EE, Sawyer M, Le T, Johnson J, Biffl WL, Cothren CC, Barnett C, Stahel P, Sillman CC, Sauaia A, Banerjee A (2010) Postinjury coagulopathy management: goal directed resuscitation via POC thrombelastography. Ann Surg 251:604–614CrossRefPubMed Kashuk JL, Moore EE, Sawyer M, Le T, Johnson J, Biffl WL, Cothren CC, Barnett C, Stahel P, Sillman CC, Sauaia A, Banerjee A (2010) Postinjury coagulopathy management: goal directed resuscitation via POC thrombelastography. Ann Surg 251:604–614CrossRefPubMed
Metadata
Title
Impact of artificial capnothorax on coagulation in patients during video-assisted thoracoscopic esophagectomy for squamous cell carcinoma
Authors
Qing-Xiang Mao
Wei Guo
Bing-Qiang Huang
Hong Yan
Publication date
01-07-2016
Publisher
Springer US
Published in
Surgical Endoscopy / Issue 7/2016
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-015-4549-3

Other articles of this Issue 7/2016

Surgical Endoscopy 7/2016 Go to the issue