Two Cases of Video-assisted Thoracoscopic Surgery Combined with Extracorporeal Membrane Oxygenation

Abstract

Video-assisted thoracoscopic surgery (VATS) has increasingly been performed in respiratory surgeries and may contribute to lighten the patient's load, however, there are some cases where patient's general condition disturbs VATS. We experienced two patients in a severe condition who were placed on one-lung ventilation during VATS. By combining with extracorporeal membrane oxygenation (ECMO), we could perform VATS in them.

Patient 1 was a 58-year-old man who suffered from bilateral pneumothorax with interstitial pneumonitis. Patient 2 was a 50-year-old woman with bilateral pneumothorax and lymphangiomyomatosis. Both patients underwent VATS with the assistance of ECMO and were taken off ECMO immediately after the surgery. Patient 1 and 2 underwent right bullectomy and bilateral pleural coverage, respectively. None of them experienced complications either during or after the surgical intervention. Although the patient 2 who was not administered anticoagulant agents had thrombosis in the jugular vein after the surgery, oral administration of edoxaban was effective, and the thrombosis disappeared immediately. The patient 1 was transferred to other hospital for rehabilitation and the patient 2 was discharged. These findings reveal that ECMO is useful for supporting patients with severe pulmonary involvement.