Published online Mar 16, 2023. doi: 10.12998/wjcc.v11.i8.1830
Peer-review started: December 15, 2022
First decision: January 17, 2023
Revised: February 25, 2023
Accepted: February 22, 2023
Article in press: February 22, 2023
Published online: March 16, 2023
Processing time: 82 Days and 2.4 Hours
Vascular injury during thoracoscopic surgery for esophageal cancer is a rare but life-threatening complication that can lead to severe hypotension and hypoxemia. Anesthesiologists need to provide rapid and effective treatment to save patients' lives.
A 54-year-old male patient was scheduled to undergo a thoracoscopic-assisted radical resection of esophageal cancer through the upper abdomen and right chest. While dissociating the esophagus from the carina through the right chest, unexpected profuse bleeding occurred from a suspected pulmonary vascular hemorrhage. While the surgeon attempted to achieve hemostasis, the patient developed severe hypoxemia. The anesthesiologist implemented continuous positive airway pressure (CPAP) using a bronchial blocker (BB), which effectively improved the patient’s oxygenation and the operation was completed success
CPAP using a BB can resolve severe hypoxemia caused by accidental injury of the left inferior pulmonary vein during surgery.
Core Tip: Although hypoxemia caused by pulmonary vein injury is a rare complication, it is life-threatening. We report such a rare case, successfully managed by continuous positive airway pressure using a bronchial blocker. We hope that this case report helps other specialists to promptly manage similar incidents and avoid treatment delays and death.