NEW OPPORTUNITIES OF INTUBATION WITH A DOUBLE LUMEN TUBE DURING THORACIC SURGERY IN THE PATIENTS WITH ABNORMAL TRACHEOBRONCHIAL ANATOMY

Abstract

The current development of oncological surgery requires maximum possible radical interventions both for the patients with concurrent conditions and those with large tumors. In thoracic surgery, provision of the adequate surgical access by the anesthesiologist is crucial, and first of all, it requires the full collapse of the operated lung for the whole time of surgery. A chest tumor often results in the changes of the trachea and main bronchi anatomy, compression of their lumen, which can make lung separation difficult. Introduction of double lumen tube with an integrated video camera into clinical practice is aimed to provide easy and reliable separation and isolation of the lungs in case of pathological changes in the trachea and main bronchi without control bronchoscopy. The article analyses 17 cases when double lumen tubes with video monitoring were used for oncological thoracic surgeries, assesses the results and opportunities for their use in the patients with the changed anatomy of the tracheobronchial tree. Video monitoring provides safe and fast intubation of the left main bronchus reaching the required depth, reduces the time of preparation for surgery and its duration providing good working conditions for surgeons.

Keywords

• lung separation
• tracheal compression
• double lumen tube
• system of etview
• vivasight-dl