By making a tunnel between the bronchovascular structures and parenchyma from anteriorly to posteriorly, one can open the fissure completely with staplers at an early stage of an anatomical lung resection. This combines the advantages of both the 'fissureless' hilum first technique and classic (open) fissure first dissection, i.e. minimal air leak and optimal anatomical overview before bronchovascular structures are divided, potentially avoiding inadvertent transections. A cohort of 198 consecutive patients operated with this alternative fissureless technique demonstrates the feasibility and non-inferiority regarding hospital stay, chest tube duration, operation time and complications in comparison with the hilum first technique.
The role of gravity in the redistribution of pulmonary blood flow during one-lung ventilation (OLV) has recently been questioned. To address this controversial but clinically important issue we used an experimental approach that allowed us to differentiate the effects of gravity from the effects of hypoxic pulmonary vasoconstriction on arterial oxygenation during OLV in patients scheduled for thoracic surgery.
MethodsForty patients with chronic obstructive pulmonary disease scheduled for right lung tumour resection, were randomized to undergo dependent (left) one-lung ventilation (D-OLV ; n=20) or non-dependent (right) one-lung ventilation (ND-OLV ; n=20) in the supine and left lateral positions. Partial pressure of arterial oxygen (PaO 2 ) was measured as a surrogate for ventilation/perfusion matching. Patients were studied before surgery in closed chest conditions.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.