胸腔鏡下食道切除術 : 腹臥位と左側臥位の麻酔管理の比較検討 Anesthetic Management of Video-assisted Thoracoscopic Esophagectomy : Comparison of Prone Position and Left Lateral Position

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  当院で行われた左側臥位の胸腔鏡下食道切除術(VATS-E)(L群)と腹臥位VATS-E(P群)各70例について後ろ向きに検討した.P群はL群と比べて胸部操作中の動脈血二酸化炭素分圧の最高値が高く,重篤な経皮的動脈血酸素飽和度低下の発生が多かった.また,体位変換の困難さに伴い麻酔導入時間が長かった.しかしP群は胸部操作中出血量,総輸液量,術中水分出納,胸部操作中の不整脈や術視野不良が有意に少なかった.腹臥位VATS-Eは呼吸管理や体位変換などの今後検討すべき問題点はあるが,循環動態は安定しており安全に管理できた.

  We retrospectively reviewed outcomes of video-assisted thoracoscopic surgery of the esophagus (VATS-E) in the left lateral position (group L, n=70) and in the prone position (group P, n=70) in our hospital. The maximum arterial carbon dioxide tension was higher and a marked reduction in percutaneous arterial oxygen saturation was more common in group P. Moreover, the induction time of anesthesia was longer in group P, in which it was more difficult to change postural position. However, the amount of bleeding, total infusion volume, intraoperative water balance, the incidence of arrhythmia, and poor surgical field visibility during thoracic manipulation were significantly lower in group P than in group L. Thus, VATS-E in the prone position provided stable hemodynamics and safe management of patients, although there remain issues to be resolved, including respiratory care and changes in postural position.

収録刊行物

  • 日本臨床麻酔学会誌 = The Journal of Japan Society for Clinical Anesthesia

    日本臨床麻酔学会誌 = The Journal of Japan Society for Clinical Anesthesia 32(3), 375-380, 2012-05-15

    日本臨床麻酔学会

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各種コード

  • NII論文ID(NAID)
    10030763252
  • NII書誌ID(NCID)
    AN00330159
  • 本文言語コード
    JPN
  • 資料種別
    ART
  • ISSN
    02854945
  • データ提供元
    CJP書誌  J-STAGE 
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