Song Lane,Zhu Xiaohong.Airway management of thoracoscopic surgery for recurrent tracheoesophageal fistula in children[J].Journal of Clinical Pediatric Surgery,,21():170-173.[doi:10.3760/cma.j.cn.101785-202011036-013]
Airway management of thoracoscopic surgery for recurrent tracheoesophageal fistula in children
- Keywords:
- Esophageal Atresia/CO; Recurrent Esophagotracheal Fistula; Thoracoscopy; One-lung Ventilation
- Abstract:
- Objective To explore the anesthetic airway management for thoracoscopic surgery (TS) of recurrent tracheoesophageal fistula (rTEF).Methods A retrospective analysis was conducted on the clinical data of 29 patients of rTEF undergoing thoracoscopic repair.Information on preoperative conditions, one-lung ventilation methods, and location and size of the fistula were collected.Changes of PETCO2 and SpO2 at 6 time points (before one-lung ventilation, one-lung ventilation for 10 minutes, 30 minutes, 60 minutes, the end of one-lung ventilation, and the end of operation) were observed.Results Varying degrees of pneumonia were found in all children before the operation.PETCO2 gradually increased with the prolonged one-lung ventilation, and then dropped after the end of one-lung ventilation (P=0.001).SpO2 dropped to below 90% in 3 children, with the lowest reaching 85%, 86%, and 87% respectively.There was no statistically significant difference in SpO2 at 6 time points (P>0.05).Conclusion For TS of rTEF the focus of anesthesia management is to avoid fistula ventilation and strengthen airway management.However, to ligate the fistula as soon as possible remains the top priority.For high fistulas and small fistula near the carina, it is feasible to adopt.one-lung ventilation methods of CO2 artificial pneumothorax, bronchial obstructor and bronchial intubation Yet for big fistula near the carina, it is best to choose the left main bronchus intubation method.
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Memo
收稿日期:2021-09-14。
通讯作者:朱晓红,Email:zxh_1006@126.com