One‐lung ventilation in obese patients undergoing thoracoscopic lobectomy for lung cancer

BACKGROUND: We evaluated the safety and feasibility of one‐lung ventilation in obese patients undergoing thoracoscopic lobectomy and whether obesity affected peri‐ and postoperative outcomes. METHODS: This was a retrospective single center study including consecutive patients undergoing thoracoscopic lobectomy between October 2019 and February 2022. Obese patients were statistically compared to a control group to evaluate any differences in relation to one‐lung ventilation and peri‐ and postoperative outcomes. RESULTS: Our study population included 111 patients; of these, 26 (23%) were included in the obese group, while 85 (77%) were included within the nonobese group. To obtain one‐lung ventilation in nonobese patients, a double‐lumen tube was more frequently used than a single‐lumen tube with bronchial blocker (61% vs. 39%; p = 0.02), while in obese patients a single‐lumen tube with bronchial blocker was used more than a double‐lumen tube (81% vs. 19%, p = 0.001). Intergroup comparison showed that a double‐lumen tube was the preferred method in nonobese patients, while a single‐lumen tube with bronchial blockers was the strategy of choice in obese patients (p = 0.0002). Intubation time was longer in the obese group than in the nonobese group (94.0 ± 6.1 vs. 85.0 ± 7.0 s; p = 0.0004) and failure rate of first attempt at intubation was higher in the obese group (23% vs. 5%; p = 0.01). Obesity was not associated with increased intra‐, peri‐ and postoperative complications and/or mortality. CONCLUSIONS: One‐lung ventilation is a feasible and safe procedure also in obese patients and obesity did not negatively affect peri‐ and postoperative outcomes after lung resection.