Two lung ventilation through single lumen tracheal tube in thoracoscopic thymectomy: a randomized clinical trial of efficacy and safety

Abstract

Background: Video assisted thoracoscopic surgery (VATS) has been successfully used for thymectomy in myasthenia gravis (MG). Thoracoscopic thymectomy (TT) is usually done under general anesthesia with double lumen tubes (DLT). The aim of this study is evaluation of two lung ventilation through single lumen tubes (SLT) during TT.

Methods: In this prospective randomized study, TT was done in 30 patients with MG from January 2004 to December 2007. Patients were randomly intubated with either a DLT or SLT, 15 patients in each group. All patients were evaluated for hemodynamic stability, oxygen saturation of hemoglobin (Spo2), end-tidal Pco2 (ETPco2), times required for intubation and surgery, satisfaction of surgeon about exposure and postoperative complications.

Results: In the SLT group, all patients had stable hemodynamic, Spo2 and ETPco2. In the DLT group, hemodynamic instability occurred in one, decrease in Spo2 in one and increase in ETPco2 in another patient. One patient in DLT group developed vocal cord granuloma two months later. Time required for surgery and surgeon's opinion about exposure were similar in the two groups.

Conclusion: SLT is safe in TT. It provides good surgical exposure and decreases the cost, time and undesirable complications of DLT.