Efficacy and hemodynamic response of pleural carbon dioxide insufflation during thoracoscopic surgery in a swine vessel injury model

Ryo Okamura, Yusuke Takahashi, Hitoshi Dejima, Takashi Nakayama, Hirofumi Uehara, Noriyuki Matsutani, Masafumi Kawamura

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Purposes: Thoracoscopic anatomical lung resection is a minimally invasive technique, but intraoperative massive bleeding is a critical complication. We investigated the hemostatic efficacy and safety of intrapleural carbon dioxide (CO2) insufflation in thoracoscopic surgery in a swine vessel injury model. Methods: Swines were assigned to one of four groups subjected to thoracoscopic surgery under target intrathoracic pressures of 0, 5, 10, or 15 mmHg CO2 insufflation, respectively. A pin-hole injury of the right cranial lobe pulmonary vein was inflicted thoracoscopically and we compared the blood loss and hemodynamic changes in each group. Results: There were no signs or echographic findings of air embolus. Both the blood loss per minute and total blood loss during the experiment were significantly lower in the 10 and 15 mmHg groups than in the 0 mmHg group (p > 0.05, respectively). The hemodynamic signs, including heart rate, mean arterial pressure, and peripheral oxygen saturation, were not significantly different in the 0 and 10 mmHg groups at most times, although they were significantly correlated with the insufflation pressure during the experiments (p < 0.05). Conclusions: CO2 insufflation in thoracoscopic major lung resection appears to be safe, even in the short term, and can help to control vessel injury.

Original languageEnglish
Pages (from-to)1464-1470
Number of pages7
JournalSurgery Today
Volume46
Issue number12
DOIs
Publication statusPublished - 2016 Dec 1
Externally publishedYes

Keywords

  • Animal model
  • Bleeding control
  • Endoscopic procedure
  • Pulmonary vein
  • VATS

ASJC Scopus subject areas

  • Surgery

Fingerprint Dive into the research topics of 'Efficacy and hemodynamic response of pleural carbon dioxide insufflation during thoracoscopic surgery in a swine vessel injury model'. Together they form a unique fingerprint.

  • Cite this

    Okamura, R., Takahashi, Y., Dejima, H., Nakayama, T., Uehara, H., Matsutani, N., & Kawamura, M. (2016). Efficacy and hemodynamic response of pleural carbon dioxide insufflation during thoracoscopic surgery in a swine vessel injury model. Surgery Today, 46(12), 1464-1470. https://doi.org/10.1007/s00595-016-1323-7