A Trial to Evaluate the Impact of Lung-protective Intervention in Patients Undergoing Esophageal Cancer Surgery

Impact of Intraoperative Protective One-lung Ventilation in Patients Undergoing Esophagectomy : a Prospective Randomized Controlled Trial

The purpose of this trial is to determine whether low tidal volume during intraoperative one-lung ventilation could decrease the incidence rate of postoperative acute lung injury compared to "normal" tidal volume.

Large tidal volume are known risk factor of acute lung injury.Mechanical ventilation with low tidal volume has been shown to attenuate lung injuries in critically ill patients.Esophagectomy surgery need a relatively long time of one-lung ventilation. A normal tidal volume of two-lung ventilation should be a large one when exerted to one lung. We hypothesized that low tidal volume ventilation during one-lung ventilation could decrease incidence rate of postoperative acute lung injury and mortality.

Inclusion Criteria:

• clinical diagnosis of esophageal carcinoma and planned for esophagectomy
• indication for one-lung ventilation
• informed consent
• ASA I~II

Exclusion Criteria:

• NYHA III~IV
• severe COPD
• pulmonary fibrosis
• any new pulmonary infiltrate on chest radiograph
• preoperative acute infection suspected
• altered liver function( Child-Pugh class B or moe)
• acute or chronic renal failure
• preoperative corticosteroid treatment during month before inclusion