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使用双侧支气管阻塞器进行差异肺通气，用于机器人支气管镜引导下的标记以及随后的双侧肺楔形切除术和肺叶切除术。

Using a Double-Sided Bronchial Blocker for Differential Lung Ventilation for Robotic Bronchoscopy-Guided Marking and Subsequent Bilateral Lung Wedge Resections and Lobectomy.

作者信息

Dixon Brett, Cohler Samuel, DeGrauw Jeffery, Hafen Ryan

机构信息

Kirk Kerkorian School of Medicine, University of Nevada, Las Vegas, Las Vegas, USA.

Anesthesiology, HCA Sunrise Health GME Consortium, Las Vegas, USA.

出版信息

Cureus. 2024 Oct 4;16(10):e70824. doi: 10.7759/cureus.70824. eCollection 2024 Oct.

DOI:10.7759/cureus.70824
PMID:39493142
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11531687/
Abstract

One-lung ventilation presents unique challenges for the anesthesiologist. We present a case where the patient underwent robotic bronchoscopy to mark the lesion locations before bilateral wedge resections and a unilateral lobectomy. An 8.5 mm endotracheal tube was used to facilitate the robotic bronchoscopy. Subsequently, an EZ-Blocker double-sided bronchial blocker was placed to selectively isolate each lung during different phases of the procedure. This clinical situation required specific equipment, rather than a traditional double-lumen tube or a one-sided bronchial blocker, to efficiently manage the patient.

摘要

单肺通气给麻醉医生带来了独特的挑战。我们呈现一个病例，该患者在进行双侧楔形切除术和单侧肺叶切除术之前，接受了机器人支气管镜检查以标记病变位置。使用了一根8.5毫米的气管导管以方便进行机器人支气管镜检查。随后，放置了一个EZ-Blocker双面支气管封堵器，以便在手术的不同阶段选择性地隔离每侧肺。这种临床情况需要特定的设备，而不是传统的双腔导管或单侧支气管封堵器，来有效地管理患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c650/11531687/1e806dc23eb1/cureus-0016-00000070824-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c650/11531687/821c70ad6afd/cureus-0016-00000070824-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c650/11531687/8bcf1e6365ac/cureus-0016-00000070824-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c650/11531687/1e806dc23eb1/cureus-0016-00000070824-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c650/11531687/821c70ad6afd/cureus-0016-00000070824-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c650/11531687/8bcf1e6365ac/cureus-0016-00000070824-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c650/11531687/1e806dc23eb1/cureus-0016-00000070824-i03.jpg

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本文引用的文献

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J Cardiothorac Surg. 2023 Apr 11;18(1):126. doi: 10.1186/s13019-023-02215-3.
2
Current Practice Issues in Thoracic Anesthesia.胸科麻醉的当前实践问题
Anesth Analg. 2021 Dec 1;133(6):1520-1531. doi: 10.1213/ANE.0000000000005707.
3
Ion: Technology and Techniques for Shape-sensing Robotic-assisted Bronchoscopy.离子：用于形态感知机器人辅助支气管镜检查的技术和技巧。
Ann Thorac Surg. 2022 Jan;113(1):308-315. doi: 10.1016/j.athoracsur.2021.06.086. Epub 2021 Aug 8.
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Comparison of single-stage and two-stage bilateral video-assisted thoracic surgery.一期和两期双侧电视辅助胸腔镜手术的比较。
J Int Med Res. 2020 Nov;48(11):300060520967558. doi: 10.1177/0300060520967558.
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The efficacy and adverse effects of the Uniblocker and left-side double-lumen tube for one-lung ventilation under the guidance of chest CT.在胸部CT引导下Uniblocker和左侧双腔管用于单肺通气的疗效及不良反应
Exp Ther Med. 2020 Apr;19(4):2751-2756. doi: 10.3892/etm.2020.8492. Epub 2020 Feb 5.
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Safety of Simultaneous Bilateral Pulmonary Resection for Metastatic Lung Tumors.转移性肺肿瘤同期双侧肺切除的安全性
Anticancer Res. 2018 Mar;38(3):1715-1719. doi: 10.21873/anticanres.12406.
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Physiologic evaluation of the patient with lung cancer being considered for resectional surgery: Diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines.肺癌切除术患者的生理学评估：肺癌的诊断与管理，第 3 版：美国胸科学会循证临床实践指南。
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