Preserving Spontaneous Breathing Without Intubation and Endotracheal Intubation with One Lung Ventilation in Single-hole Thoracoscopic Bulla Suture

Abstract

Objective: To explore the situation of patients and the compare the effect between two methods, which are preserving spontaneous breathing without intubation and endotracheal intubation with one lung ventilation in the single-hole thoracoscopic bulla suture. Method: 42 patients who received single-hole thoracoscopic pulmonary bullae suture in our hospital from January 2020 to December 2021 were selected as the study subjects, including 19 patients who underwent endotracheal intubation and one lung ventilation as the control group and 23 patients who underwent single-hole thoracoscopic pulmonary bullae suture without intubation as the study group. The relevant indexes, postoperative general conditions, complications and pneumothorax recurrence of the two groups were analyzed and observed. Results: In the control group, the scores of anesthesia time (points), resuscitation time (points), surgical visual field score (points), surgical time (points), and surgical bleeding volume (points) were 20.8 ± 4.6, 19.9 ± 7.9, 1.7 ± 0.5, 44.9 ± 7.9, and 11.4 ± 2.4 respectively. In the study group, the scores of anesthesia time (points), resuscitation time (points), surgical visual field score (points), surgical time (points), and scores of surgical bleeding (points) were 17.9 ± 4.3, 15.4 ± 3.4, 1.9 ± 0.4, 48.4 ± 7.1, 10.9 ± 2.2, respectively. There was no statistical difference in surgical visual field score, surgical time and surgical bleeding whereas there was a statistical difference between anesthesia time and resuscitation time. In the control group after operation, VAS score at 6 hours after operation, SaO₂ (%) after operation, PaCO₂ (mmHg) after operation, drainage volume (ML) after operation, feeding time (H) after operation, retention time of thoracic tube after operation (H), WBC (109) on the first day after operation, hospitalization time (d), and total hospitalization cost (RMB 1000) were 2.1 ± 0.7, 98.2 ± 1.4, 42.4 ± 4.9, 139.1 ± 23.1, 6.9 ± 1.6, 37.1 ± 5.4, 7.9 ± 2.1, 6.6 ± 1.3, and 2.6 ± 0.3 respectively. As for the study group, the VAS score at 6 hours after operation, SaO₂ (%) after operation, PaCO₂ (mmHg) after operation, drainage volume (ML) after operation, feeding time (H) after operation, retention time of thoracic tube after operation (H), WBC (109) on the first day after operation, hospitalization time (d), and total hospitalization cost (RMB 1000) were 1.9 ± 0.4, 97.9 ± 1.2, 42.8 ± 5.1, 151.8 ± 21.9, 4.3 ± 1.4, 15.3 ± 2.6, 5.2 ± 2.3, 4.2 ± 1.2, and 1.8 ± 0.4 respectively. Among them, there were no significant differences in visual analog scale (VAS) score at 6 hours after operation, SaO₂ after operation and PaCO₂ after operation between the two groups, but there were significant differences in other factors. The complication rate of the control group was 36.84%, which was significantly higher than that of the study group (4.35%), with statistical difference. The recurrence rate of the control group was 21.05%, which was not significantly different from that of the study group (4.35%). Conclusion: The single-hole thoracoscopic bullae suture without intubation can reduce the anesthesia time and resuscitation time of patients, reduce the hospitalization cost of patients, reduce the treatment burden, shorten the first feeding time, and reduce the complication rate of patients. Therefore, it is worthy of clinical promotion.