Affiliation:
1. Research Institute of Pediatric Oncology and Hematology of N.N. Blokhin National Medical Research Centre of Oncology, Ministry of Health of Russia
2. Research Institute of Pediatric Oncology and Hematology of N.N. Blokhin National Medical Research Centre of Oncology, Ministry of Health of Russia; N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia
Abstract
Introduction. Treatment of children with mediastinal and lung tumors is an urgent problem in both surgery and anesthesiology. Main goal is to grant optimal conditions for the surgery – collapse of the lung on the side of the operation, while maintaining adequate oxygenation and efficient transport of oxygen to the tissues. The choice of devices for carrying out one-lung ventilation (OLV) is the most important factor determining the safety of the patient.Aim of the study. To increase the efficiency and safety of anesthesia for thoracic surgeries in children due to the use of bronchial blockers (BB) for one-lung ventilation (OLV). Materials and methods. 92 surgeries were performed (49 – thoracoscopic, 43 – thoracotomies) in 11–17 years old 92 patients. Patients were randomly divided into two groups: BB group (n = 56) – OLV was performed using bronchial blocker; double-lumen tubes (DLT) group (n = 36) – OLV was performed using a DLT. Ventilation parameters, hemodynamics, the incidence of complications in the perioperative and postoperative periods were recorded.Results. A much less prolonged lungs separation time in BB group was found compared to the DLT group (65.32 ± 17.32 sec versus 99.0 ± 9.03 sec respectively, p < 0.0001) and a lower frequency of repositioning (0.2 ± 0.4 and 0.57 ± 0.51 respectively, p = 0.04). In patients with BB, less complications were recorded, such as postoperative aphonia and sore throat.Conclusion. BB demonstrate efficacy and safety in OLV management for thoracic surgeries in pediatric oncology. They provide faster lungs separation time than DLT, irrespective of the side of the surgery, allow complete collabation of the lung with a less frequent need for repositioning. The introduction of a new method of OLV with the use of BB in children is associated with reduction of the length of stay of patients in the intensive care unit during the postoperative period due to the reduction in complications such as trauma of the main bronchi, aphonia and sore throat.
Subject
Oncology,Hematology,Pediatrics, Perinatology and Child Health
Reference19 articles.
1. Erginel B., Soysal F.G., Keskin E., Kebudi R., Celik A., Salman T. Pulmonary metastasectomy in pediatric patients. World J Surg Oncol 2015;14:27. doi: 10.1186/s12957-016-0788-6.
2. Yamamoto Y., Kanzaki R., Kanou T. Long-term outcomes and prognostic factors of pulmonary metastasectomy for osteosarcoma and soft tissue sarcoma. Int J Clin Oncol 2019;24:863–70. doi:10.1007/s10147-019-01422-0.
3. Fuchs J., Seitz G., Handgretinger R., Schäfer J., Warmann S.W. Surgical treatment of lung metastases in patients with embryonal pediatric solid tumors: an update. Semin Pediatr Surg 2012;21(1):79–87. doi: 10.1053/j.sempedsurg.2011.10.008.
4. Falzon D., Alston R.P., Coley E., Montgomery K. Lung Isolation for Thoracic Surgery: From Inception to Evidence-Based. J Cardiothorac Vasc Anesth 2017;31(2):678–93. doi: 10.1053/j.jvca.2016.05.032.
5. Gruzdev V.E., Gorobets E.S., Afanasenkov A.A. New opportunities of intubation with a double lumen tube during thoracic surgery in the patients with abnormal tracheobronchial anatomy. Vestnik anesteziologii i reanimatologii = Messenger of Anesthesiology and Resuscitation 2018;15(1):27–31. (In Russ.) doi: 10.21292/2078-5658-2018-15-1-27-3.
Cited by
1 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献