학술논문
Airway Management of the Right Anterior Segmentectomy through Uniportal video-assisted thoracoscopic surgery (VATS) after left pneumonectomy by an adapted double-lumen endobronchial tube (DLT): a case report
Document Type
Clinical report
Author
Source
BMC Anesthesiology. May 20, 2019, Vol. 19 Issue 1
Subject
Language
English
ISSN
1471-2253
Abstract
Author(s): Yang Gu[sup.1] , Ruowang Duan[sup.1] , Xin Lv[sup.1] and Jiong Song[sup.1] Background Contralateral lung resection in postpneumonectomy patient is rare due to its significant perioperative mortality [1]. Thus, the [...]
Background Lung resection after previous contralateral pneumonectomy is rare. We present a case of right anterior segmentectomy despite previous left pneumonectomy, demanding special airway management strategy. Case presentation A 48-year-old woman who had left pneumonectomy 2 years ago was scheduled to have the right anterior segmentectomy through uniportal video-assisted thoracoscopy (VATS). A 32-French (Fr) left-sided double-lumen endobronchial tube (DLT) was chosen and adapted. The DLT was intubated into the bronchus intermedius. And the upper lobe can be isolated from the ventilation in the middle and lower lobes when the bronchial cuff's inflated. The perioperative period was uneventful and the pathological diagnosis was adenocarcinoma. Conclusion Lung cancer radical resection was discouraged after previous contralateral pneumonectomy partly due to the challenging ventilation and isolation. With this new DLT adapting and intubation technique showed in this case, the challenging ventilation and isolation that deter the implementation of the operation mentioned above could be solved. Keywords: Double-lumen endobronchial tube, Pneumonectomy, Ventilation, Isolation
Background Lung resection after previous contralateral pneumonectomy is rare. We present a case of right anterior segmentectomy despite previous left pneumonectomy, demanding special airway management strategy. Case presentation A 48-year-old woman who had left pneumonectomy 2 years ago was scheduled to have the right anterior segmentectomy through uniportal video-assisted thoracoscopy (VATS). A 32-French (Fr) left-sided double-lumen endobronchial tube (DLT) was chosen and adapted. The DLT was intubated into the bronchus intermedius. And the upper lobe can be isolated from the ventilation in the middle and lower lobes when the bronchial cuff's inflated. The perioperative period was uneventful and the pathological diagnosis was adenocarcinoma. Conclusion Lung cancer radical resection was discouraged after previous contralateral pneumonectomy partly due to the challenging ventilation and isolation. With this new DLT adapting and intubation technique showed in this case, the challenging ventilation and isolation that deter the implementation of the operation mentioned above could be solved. Keywords: Double-lumen endobronchial tube, Pneumonectomy, Ventilation, Isolation