Objective      To investigate the effect of continuous positive airway pressure (CPAP) in collapsed lung on the lung injury after the thoracoscopic and laparoscopic surgery for esophageal carcinoma.       Methods      Fifty esophageal carcinoma patients (ASA grade II to III

aged 40 to 75

with body mass index of 18 to 27) undergo

ing selective thoracoscopic and laparoscopic esophagectomy in our hospital were prospectively enrolled in this study. They were randomly divided into control group (n=25

the collapsed lung directly connected to the outside air in one lung ventilation) and CPAP group (n=25

application of 6 cmH

2

O CPAP to the collapsed lung during one-lung ventilation). Serum levels of soluble receptor of advanced glycation end-products (sRAGE) and krebs von den lungen-6 (KL-6) were detected with ELISA at 3 time points

that is

before operation (T1)

at the end of one lung ventilation (T2)

and 24 h after operation (T3). Arterial blood gas analysis was carried out to calculate the oxygenation index (OI).       Results      The OI values were significantly decreased in both groups at T2 and T3 than those at T1 (P0.05)

and it was significantly higher at T2 in the CPAP group than the control (P0.05). sRAGE and KL-6 levels were markedly elevated in both groups at T3 than T1 and T2 (P0.05). sRAGE and KL-6 were significantly decreased in the CPAP group than control at T3 (P0.05).       Conclusion      CPAP in collapsed lung during one lung ventilation might reduce the lung injury after the thoracoscopic and laparoscopic surgery for esophageal carcinoma.