Iizuka Toru, Shimoyama Naohito, Fuggiano Luigi, Notoya Atsuko
Department of Anesthesia, National Cancer Center Hospital, Tokyo 104-0045.
Masui. 2010 Dec;59(12):1548-51.
One-lung ventilation and lung isolation are frequently required in thoracic surgery. In clinical practice, lung isolation is achieved by use of a double-lumen endotracheal tube and a bronchial blocker. A novel bagel shaped bronchial blocker, the Fuggiano's bronchial blocker, has been designed to prevent displacement of the blocker from its position in the bronchus. In this study, we evaluated the clinical performance of the Fuggiano's bronchial blocker for the lung isolation.
In thirty patients undergoing thoracotomy or video-assisted thoracoscopic surgery, the Fuggiano's bronchial blockers were placed to the bronchus. Fifteen patients received a left-sided bronchial block, and fifteen a right-sided block. The position of the devices was checked using fibreoptic bronchoscope.
In all cases, successful lung isolation and the properly collapsed lung were achieved. It took significantly longer time to place a right bronchial block. Intraoperative repositioning of the device was not required. The quality of lung deflation was judged excellent in all patients.
We conclude that, for routine use, the Fuggiano's bronchial blocker is preferable to achieve a lung isolation because of its facility in placement and a better quality of lung deflation. Fuggiano's bronchial blocker may be an alternative airway device for one-lung ventilation, and further work is required.
胸外科手术中经常需要进行单肺通气和肺隔离。在临床实践中，肺隔离是通过使用双腔气管导管和支气管封堵器来实现的。一种新型的百吉饼形状的支气管封堵器，即富贾诺支气管封堵器，已被设计用于防止封堵器在支气管内的位置发生移位。在本研究中，我们评估了富贾诺支气管封堵器用于肺隔离的临床性能。
在30例接受开胸手术或电视辅助胸腔镜手术的患者中，将富贾诺支气管封堵器放置于支气管内。15例患者接受左侧支气管封堵，15例接受右侧封堵。使用纤维支气管镜检查封堵器的位置。
在所有病例中，均成功实现了肺隔离且肺充分萎陷。放置右侧支气管封堵所需时间明显更长。术中无需重新调整封堵器位置。所有患者的肺萎陷质量均被判定为优秀。
我们得出结论，对于常规使用，富贾诺支气管封堵器因其放置简便且肺萎陷质量更好，在实现肺隔离方面更具优势。富贾诺支气管封堵器可能是单肺通气的一种替代气道装置，还需要进一步的研究。
