Journal of laparoendoscopic & advanced surgical techniques. Part A
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J Laparoendosc Adv Surg Tech A · Sep 2011
Case ReportsThoracoscopic enucleation of esophageal gastrointestinal stromal tumor using prone positioning in a patient with severe chronic obstructive lung disease.
Abstract Chronic obstructive lung disease (COPD) is a high-risk factor for pulmonary complications in esophageal surgery. We reported a case of esophageal gastrointestinal stromal tumor (GIST) in a patient with severe COPD. Upper gastrointestinal endoscopy and computed tomography revealed a 3×2-cm submucosal tumor at the lower esophagus, and positron emission tomography showed a hypermetabolic mass (SUV(max)=5.6). ⋯ Taking the patient's lung function into account, we performed a thoracoscopic enucleation for the esophageal GIST while the patient was in a prone position. The postoperative course was uneventful and no significant change was observed in the patient's respiratory condition. Performing thoracoscopic surgery on COPD patients in a prone position is a good therapeutic alternative for reducing the occurrence of pulmonary complications.
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J Laparoendosc Adv Surg Tech A · Sep 2011
Randomized Controlled Trial Comparative StudyEffect of pressure- versus volume-controlled ventilation on the ventilatory and hemodynamic parameters during laparoscopic appendectomy in children: a prospective, randomized study.
Several ventilatory strategies have been introduced to minimize the respiratory and hemodynamic effects of carbon dioxide pneumoperitoneum during laparoscopic surgery. The purpose of this study was to compare the effects of pressure-controlled ventilation (PCV) with that of volume-controlled ventilation (VCV) on the ventilatory and hemodynamic parameters in children undergoing laparoscopic appendectomy. ⋯ During laparoscopy, mean airway pressure and dynamic compliance were significantly higher during PCV with 5 cm H(2)O PEEP compared with that in VCV with 5 cm H(2)O PEEP. And, as there were no differences in other ventilatory parameters and oxygen saturation, both VCV and PCV can be used safely in children undergoing laparoscopic surgery.