Carbon Dioxide Pneumothorax Following Retroperitoneal Laparoscopic Partial Nephrectomy

A Case Report and Literature Review

Qiongfang Wu; Hong Zhang


BMC Anesthesiol. 2018;18(202) 

In This Article


Laparoscopic surgeries have been widely performed because they have so many advantages as less invasiveness, less postoperative pain, shorter hospital stay and better cosmesis.[1] However, they may also cause severe complications like pneumothorax, pneumomediastinum and subcutaneous emphysema.[2] Laparoscopic partial nephrectomy, which could be performed through insufflating carbon dioxide (CO2) in either the retroperitoneal or peritoneal space to achieve a better view, has been widely used for surgical treatment for T1 stage renal tumor. Pneumothorax is a recognized complication of laparoscopic surgery.[3,4] Although the incidence of pneumothorax in laparoscopic renal surgery is less than 1%, it's potentially serious and life-threatening,[5] requiring rapid recognition and treatment. For patients with large pneumothorax or obvious symptoms, the common practice is to place a chest tube for drainage. However, CO2 pneumothorax is distinct from air pneumothorax in that CO2 is highly soluble in blood and could be absorbed rapidly.[6,7] Here, we present a case with an unexpected large volume of CO2 pneumothorax and severe symptoms, which was managed conservatively.