[Anesthetic management of patients with tracheal bronchus].

The incidence of a tracheal bronchus supplying the right upper lobe has been reported to be in the range of 0.1 to 3%. We encountered 3 cases with the anomaly among 200 cases of lung surgery conducted over a year at our hospital. In the first case, we had difficulty in intubating the patient with a double-lumen tube. In the other two cases, the tracheal bronchus was detected by fiberoptic bronchoscopy during the lung surgery. Patients with a tracheal bronchus may be difficult or impossible to ventilate, especially when requiring unilateral lung ventilation. Therefore, the airway must be assessed carefully by fiberoptic bronchoscopy prior to unilateral lung surgery, keeping in mind the possibility of a tracheal bronchus, in order to design a safe way to secure it safely during the surgery.