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胸腔鏡下手術に関連する心肺機能不全がしばしば認められる.(1)炭酸ガス吹き込みは胸腔内の視野を改善するが,循環抑制を引き起こす.(2)胸腔鏡下肺容量減少術は重症肺気腫の低侵襲治療であるが,麻酔覚醒後に高炭酸ガス血症(通常70mmHg以上)が起こる.(3)肺切除術後や食道離断術後に心房細動が高い頻度で出現する.これらの合併症の治療と予防について述べる.
Cardiac and/or pulmonary dysfunctions related to thoracoscopic surgery occur frequently. Carbon dioxide insufflation during thoracoscopy, although facilitates exposure of the intrathoracic structures, results in hemodynamic compromise. Thoracoscopic lung volume reduction surgery is a minimally invasive treatment for severe pulmonary emphysema, but hypercapnia, more than 70 mmHg, deverops after emergence from anesthe-sia. Atrial fibrillation is common after lung surgery and esophagectomy. The treatment and prophylaxis of these complications are discussed.
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