During thoracic surgery, double-lumen endotracheal intubation with one-lung ventilation is routinely performed to optimize surgical exposure, facilitate operative manipulation, and prevent iatrogenic lung injury. In patients undergoing repeat pulmonary surgery, prior lung resection may lead to pleural adhesions and tracheobronchial distortion, which substantially increase the difficulty of bronchial intubation. Even with experienced operators, the malposition rate of conventional double-lumen tubes remains high. The video double-lumen tube enables continuous visualization of the trachea and carina during insertion, positioning, and one-lung ventilation, allowing real-time airway monitoring. However, no clinical studies have specifically investigated airway management in patients undergoing redo pulmonary surgery. This study aimed to evaluate the efficacy and safety of the video double-lumen tube during anesthesia in patients undergoing secondary pulmonary resection.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
SINGLE
Enrollment
500
Use the video double-lumen tube to perform left bronchial intubation under real-time visualization and continuously monitor its position.
Insert a conventional left-sided double-lumen tube using standard intubation techniques.
The First Affiliated Hospital, Zhejiang University School of Medicine
Hangzhou, Zhejiang, China
Zhejiang Cancer hospital
Hangzhou, Zhejiang, China
The Fourth Affiliated Hospital, Zhejiang University School of Medicine
Yiwu, Zhejiang, China
Success rate of first-attempt bronchial intubation
Time frame: During the first intubation attempt
Intubation time
Time frame: Measured from insertion of the video laryngoscope into the mouth until confirmation of correct tube position
Requirement for and number of fiberoptic bronchoscopy uses
Time frame: During the entire intraoperative period
Frequency of intraoperative tube repositioning
Time frame: During the entire intraoperative period
Surgeon's rating of lung collapse quality
Time frame: During the entire intraoperative period
Incidence of difficult intubation
Time frame: At the time of intubation
Intubation-related adverse events
Time frame: From the start of intubation until 24 hours postoperatively
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