Matsumura Y, Sakurada A, Saito R, Kondo T, Fujimura S
Department of Thoracic Surgery, Tohoku University, Sendai, Japan.
Kyobu Geka. 1996 Dec;49(13):1078-80.
We experienced two cases of lung cancer with terminal tracheostomy. Conventional double lumen tubes such as the Broncho-Cath or the Robertshaw were not applicable for one-lung anesthesia for these cases because of anatomical reasons due to the total laryngectomy. One left lower sleeve lobectomy and a right middle lobectomy were performed under one-lung ventilation using an occlusion balloon catheter that was introduced through a seath placed in the spiral type tracheostomy tube through a plastic connector. This method has three advantages: 1) a spiral type tracheostomy tube is easily fitted for the deformed trachea. 2) an occlusion balloon catheter with an extra lumen at its tip enables the airway aspiration and the inflation of the lung. 3) air leakage around a catheter is completely prevented by the use of a catheter introducer. The present method was concluded to be superior to the prior technique with the Forgaty catheter as an endbronchial blocker.
我们遇到了两例肺癌患者接受终末期气管造口术的情况。由于全喉切除术后的解剖学原因，传统的双腔导管如支气管导管（Broncho-Cath）或罗伯特肖导管（Robertshaw）不适用于这些病例的单肺麻醉。在单肺通气下，通过一个塑料连接器，将一个封堵球囊导管经置于螺旋型气管造口管的套管引入，分别实施了一例左肺下叶袖状切除术和一例右肺中叶切除术。该方法具有三个优点：1）螺旋型气管造口管易于适配变形的气管。2）尖端带有额外腔道的封堵球囊导管能够进行气道吸引和肺充气。3）使用导管导入器可完全防止导管周围漏气。结论是，本方法优于使用福格蒂导管（Forgaty catheter）作为支气管封堵器的先前技术。
