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Case Report
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| Hypoxemia in minimally invasive esophagectomy for squamous cell carcinoma of lower esophagus | ||||||
| Pak Lun Lam1, Lam Viet Trung2 | ||||||
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1Medical Student, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.
2Chief of Service, Department of Digestive Surgery, Cho Ray Hospital, Ho Chi Minh City, Vietnam. | ||||||
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| How to cite this article |
| Lam PL, Trung LV. Hypoxemia in minimally invasive esophagectomy for squamous cell carcinoma of lower esophagus. Int J Case Rep Images 2017;8(3):213–216. |
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Abstract
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Introduction:
Minimally invasive esophage-ctomy for esophageal cancer is the surgical treatment-of-choice, and comprises both thoracoscopy and laparoscopy. The risk of hypoxemia arises during one-lung ventilation in the thoracoscopy stage, especially for patients with reduced lung function, and thus poses significant threat to the surgical outcome. This case report aims to demonstrate one possible solution to minimize hypoxemia in minimally invasive esophagectomy.
Case Report: A 55-year-old Southeast-Asian male, with a history of chronic smoking, was presented with dysphagia. Diagnosis of squamous cell carcinoma was made, and minimally invasive esophagectomy was performed. Hypoxemia occurred during the thoracoscopic stage, and the oxygen saturation was stabilized with introduction of positive end-expiratory pressure of 5 cmH2O to reduce atelectasis, and tilting the operating table to the ventilated lung to improve perfusion by gravity. Conclusion: Minimally invasive esophagectomy may be complicated by hypoxemia during one-lung ventilation. One possible solution, as demonstrated in this case report, is the provision of a 5 cmH2O positive end-expiratory pressure, and approaching the thoracoscopic stage in a lateral decubitus position with the operating table tilted to the ventilated lung. | |
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Keywords:
End-expiratory pressure, Esophagectomy, Hypoxemia
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Author Contributions
Pak Lun Lam – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published Trung, Lam Viet – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published |
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Guarantor of submission
The corresponding author is the guarantor of submission. |
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Source of support
None |
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Conflict of interest
Authors declare no conflict of interest. |
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Copyright
© 2017 Pak Lun Lam et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information. |
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