Granell Manuel, Ferrer Nicolás, Guijarro Ricardo, De Andrés Jose
From the Department of Anesthesiology, Hospital General Universitario de Valencia, Spain (MG, NF, JDA), and Department of Thoracic Surgery, Hospital General Universitario de Valencia, Spain (RG).
Eur J Anaesthesiol Intensive Care. 2025 Jul 29;4(4):e0080. doi: 10.1097/EA9.0000000000000080. eCollection 2025 Aug.
Tracheal bronchus is a rare anatomical variant (prevalence ∼1%) that complicates lung isolation during thoracic surgery. We present an airway management approach using a double-lumen tube with an integrated camera (VivaSight DL) in a patient with this anomaly, highlighting the importance of preoperative imaging and device selection.
A 46-year-old male with an incidental tracheal bronchus underwent left upper lobectomy. Preoperative assessment included virtual bronchoscopy, computed tomography (CT) with 3D reconstruction and flexible bronchoscopy, confirming the aberrant bronchus originating 2 cm above the carina. A 37Fr left-sided video double-lumen tube was inserted under real-time guidance using its integrated camera, with tracheal bronchus patency confirmed by flexible bronchoscopy through the tracheal lumen. One-lung ventilation was achieved without complications.
In tracheal bronchus cases, preoperative CT with 3D reconstruction and bronchoscopy are critical for airway planning. Using a double-lumen tube with an integrated camera facilitates safe lung isolation by allowing real-time visual confirmation of anatomy and cuff positioning.
气管支气管是一种罕见的解剖变异（发生率约为1%），会使胸外科手术中的肺隔离变得复杂。我们介绍了一种在患有这种异常的患者中使用带有集成摄像头的双腔管（VivaSight DL）的气道管理方法，强调了术前成像和设备选择的重要性。
一名偶然发现气管支气管的46岁男性接受了左上肺叶切除术。术前评估包括虚拟支气管镜检查、三维重建计算机断层扫描（CT）和柔性支气管镜检查，证实异常支气管起源于隆突上方2厘米处。在实时引导下使用其集成摄像头插入一根37Fr左侧视频双腔管，通过气管腔的柔性支气管镜检查确认气管支气管通畅。实现了单肺通气且无并发症。
在气管支气管病例中，术前三维重建CT和支气管镜检查对气道规划至关重要。使用带有集成摄像头的双腔管可通过实时视觉确认解剖结构和套囊位置来促进安全的肺隔离。
