Abstract: Objective To investigate the effects of disconnection technique at different times on lung collapse for one‑lung ventilation (OLV) during video‑assisted thoracoscopic surgery (VATS). Methods A total of 60 patients, aged 18 to 65 years, American Society of Anesthesiologists (ASA)ⅠorⅡ, with forced expiratory volume in one second (FEV1)>80% of predicted value, who were scheduled for thoracoscopic pulmonary lesion resection under general anesthesia were enrolled. According to the random number table method, they were divided into three groups (n=20): group C (where conventional OLV was performed when the skin was incised), group D1 (where OLV was performed when the two‑lungs ventilation disconnected for 60 s after skin incision) and group D2 (where OLV was performed when the two‑lungs ventilation disconnected for 60 s after the pleura was incised). The quality of lung collapse was recorded immediately after (T0) and 5 min (T1), 10 min (T2), and 20 min (T3) after pleura incision. The time of complete lung collapse, the overall surgeon satisfaction, the time required to open the pleura, the time of pure oxygen inhaling into the lungs before OLV, the OLV time, the operation time, the incidence of hypoxemia and other complications were recorded. Results During OLV, the time of complete lung collapse in groups D1 and D2 was shorter than that in group C (P<0.05), and the overall surgeon satisfaction was higher than that in group C (P<0.05); and the time of complete lung collapse in group D2 was shorter than that in group D1 (P<0.05), and the overall surgeon satisfaction was higher than that in group D1 (P<0.05). No hypoxemia or other complications occurred in the three groups during operation. There were no statistical differences in the time required to open the pleura, the time of pure oxygen inhaling into the lungs before OLV, the operation time and the OLV time among three groups (P>0.05). Compared with group C, group D2 presented decreases in the proportion of extremely poor and poor lung collapse and increases in the proportion of good lung collapse at T0 (P<0.05); decreases in the proportion of poor grade and increases in the proportion of good grade at T1 and T2 (P<0.05); and decreases in the proportion of good grade and increases in the proportion of excellent grade at T3 (P<0.05). Compared with group D1, group D2 showed decreases in the proportion of extremely poor and poor lung collapse and increases in the proportion of good lung collapse at T0 (P<0.05); and decreases in the proportion of poor grade and increases in the proportion of good grade at T1 (P<0.05). The other differences were not statistically significant (P>0.05). Conclusions Disconnection technique improves the collapse of the non‑ventilated lung in VATS patients during OLV, which can achieve shorter lung collapse time during pleura incision, higher overall surgeon satisfaction, and better quality of lung collapse in the early stage of OLV.
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