Abstract：
OBJECTIVE: Percutaneous lung tumor ablations are mostly performed in computed tomography (CT) rooms under local anesthesia with conscious sedation. However, maintaining the breath-hold phase during this can be challenging, affecting image quality and increasing complications. With the advent of hybrid operating rooms (HORs), this procedure can be performed with endotracheal tube (ETGA) intubation under general anesthesia with lung separation, ensuring precise imaging in a single-stage setting. Lung separation provides surgical exposure of one lung while ensuring ample gas exchange with the other. This study evaluated tumor ablations performed in an HOR equipped with cone beam CT and laser guidance.
METHODS: This retrospective study included patients who underwent lung tumor ablation under general anesthesia with an ETGA in an HOR between July 2020 and May 2023. Anesthesia considerations, perioperative management, and postoperative follow-ups were evaluated.
RESULTS: 65 patients (78 tumors) underwent ablation using two types of lung ventilation methods including a single-lumen tube with a blocker (SLT/BL) (n = 15) and double-lumen tube (DLT) (n = 50). Most patients experienced desaturation during the apnea phase of dynamic CT and needling. The average SpO2 value was significantly lower in the DLT group than in the SLT/BL group during the procedure (81.1% versus 88.7%, P = 0.033). Five, three, and two patients developed pneumothorax, subcutaneous emphysema, and pleural effusion, respectively.
CONCLUSIONS: Percutaneous ablation under general anesthesia with endotracheal intubation and lung separation performed in HORs was feasible and safe. The setup minimized complication risks and maintained a balance between patient safety and successful procedures.
METHODS: This retrospective study included patients who underwent lung tumor ablation under general anesthesia with an ETGA in an HOR between July 2020 and May 2023. Anesthesia considerations, perioperative management, and postoperative follow-ups were evaluated.
RESULTS: 65 patients (78 tumors) underwent ablation using two types of lung ventilation methods including a single-lumen tube with a blocker (SLT/BL) (n = 15) and double-lumen tube (DLT) (n = 50). Most patients experienced desaturation during the apnea phase of dynamic CT and needling. The average SpO2 value was significantly lower in the DLT group than in the SLT/BL group during the procedure (81.1% versus 88.7%, P = 0.033). Five, three, and two patients developed pneumothorax, subcutaneous emphysema, and pleural effusion, respectively.
CONCLUSIONS: Percutaneous ablation under general anesthesia with endotracheal intubation and lung separation performed in HORs was feasible and safe. The setup minimized complication risks and maintained a balance between patient safety and successful procedures.
摘要：
目的：经皮肺肿瘤消融大多在计算机断层扫描（CT）室进行，局部麻醉和清醒镇静。然而,在此期间保持屏气阶段可能具有挑战性，影响图像质量和增加并发症。随着混合手术室(HORs)的出现，该程序可以在全身麻醉下进行气管导管（ETGA）插管，并进行肺分离，确保在一个单一的阶段设置精确的成像。肺分离提供一个肺的手术暴露，同时确保与另一个充分的气体交换。这项研究评估了在配备锥形束CT和激光引导的HOR中进行的肿瘤消融。
方法：这项回顾性研究包括在2020年7月至2023年5月期间在全麻下在HOR中使用ETGA进行肺肿瘤消融的患者。麻醉方面的考虑,围手术期管理,术后随访进行评估。
结果：65例患者（78个肿瘤）使用两种类型的肺通气方法进行了消融，包括带有阻滞剂的单腔管（SLT/BL）（n=15）和双腔管（DLT）（n=50）。大多数患者在动态CT和针刺的呼吸暂停阶段经历了去饱和。术中DLT组的平均SpO2值显着低于SLT/BL组（81.1％对88.7％，P=0.033)。五、三,两名患者出现气胸,皮下气肿,和胸腔积液,分别。
结论：全身麻醉下气管插管经皮消融并在HOR中进行肺分离是可行且安全的。该设置将并发症风险降至最低，并在患者安全和成功手术之间保持平衡。
方法：这项回顾性研究包括在2020年7月至2023年5月期间在全麻下在HOR中使用ETGA进行肺肿瘤消融的患者。麻醉方面的考虑,围手术期管理,术后随访进行评估。
结果：65例患者（78个肿瘤）使用两种类型的肺通气方法进行了消融，包括带有阻滞剂的单腔管（SLT/BL）（n=15）和双腔管（DLT）（n=50）。大多数患者在动态CT和针刺的呼吸暂停阶段经历了去饱和。术中DLT组的平均SpO2值显着低于SLT/BL组（81.1％对88.7％，P=0.033)。五、三,两名患者出现气胸,皮下气肿,和胸腔积液,分别。
结论：全身麻醉下气管插管经皮消融并在HOR中进行肺分离是可行且安全的。该设置将并发症风险降至最低，并在患者安全和成功手术之间保持平衡。
