Novel Approach For Isolated Left Endobronchial Intubation With Single Lumen Tube In Paediatric Patients
Journal Title: IOSR Journals (IOSR Journal of Computer Engineering) - Year 2016, Vol 18, Issue 2
Abstract
Background: Right thoracoscopy requires selective left endobronchial intubation which is technically difficult and demanding. We are presenting our experience of selective left bronchus intubation without any guidance,using a novel technique. Methods: 39 consecutive children below 12 years underwent right thoracoscopy from June 2014- Jan 2016. Endotracheal tube was kept in the freezer for 60 seconds to provide slight stiffness. Selective left bronchial intubation was done using neck extension, head tilt towards the right and left chest elevation maneuver. The tip of tube was rotated by 90° after 9cm to guide it towards left main bronchus. Maximum of three attempts weretried and ET tube kept in the trachea if selective intubation was not possible.Results: Selective left bronchus intubation could be done in 38 (97.4%). Follow-up ranged from 3 to 12 months. All cases were asymptomatic at last follow up. Selective intubation could be done on first attempt in 34(87.1%), second attempt in 3(7.6%), third attempt in 1(2.5%) and 1(2.5%) patient’s left endobronchial intubation could not be achieved. Mean operating time was 1.30 hours (Range: 1.00-2.30 hours). There were 36 empyeama(tubercular-13), 2 hydratid cysts and 1 esophageal duplication cyst. The intercostal drain was kept for a mean period of 3 days (Range: 2-4 days). All the cases were kept nil orally for 6 hours and discharged at a mean duration of 5 days (Range 4-6 days). Conclusions: Thoracoscopic procedures for right sided pathology could safely and easily be performed using this novel technique.
Authors and Affiliations
Basant Chaurasia, Sewak Ram Verma , Nitin Sharma
Keywords
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