TY - JOUR
T1 - Comparison of Endobronchial Intubation Versus Bronchial Blockade for Elective Pulmonary Lobectomy of Congenital Lung Anomalies in Small Children
AU - Kaplan, Harrison J.
AU - Lee, Rebecca E.
AU - Coakley, Brian A.
N1 - Publisher Copyright:
Copyright © 2022 Mary Ann Liebert, Inc.
PY - 2022/7/1
Y1 - 2022/7/1
N2 - Purpose: Resection of many congenital lung lesions is commonly performed under single-lung ventilation, which helps collapse the lung being manipulated and enables a thoracoscopic approach in most cases. We set out to determine whether lung isolation achieved by either main stem intubation or usage of a bronchial blocker was associated with superior clinical outcomes. Materials and Methods: A retrospective review of all patients aged <2 years undergoing elective pulmonary lobectomy for congenital lung malformations at a tertiary-care pediatric hospital from 2011 through 2020 was performed. Demographic data, diagnosis type, type of lung isolation method employed, and perioperative outcomes were recorded. Continuous variables were analyzed with Student's t-tests, whereas categorical variables were analyzed with Fisher's exact tests and chi-square tests. Results: Thirty-two patients were analyzed - 17 were managed with a bronchial blocker while 15 underwent main stem intubation. The most common diagnoses were congenital pulmonary airway malformations (53.1%) and intralobar bronchopulmonary sequestrations (34.4%). Patients managed with main stem intubation were slightly younger (P = .06) than those for which a bronchial blocker was used. Thirty-one (96.9%) resections were initiated thoracoscopically. Main stem intubation was associated with shorter operative times (P = .01), shorter anesthetic times (P = .02), and less blood loss (P = .04). No differences in length of stay (P = .64), conversation to thoracotomy (P = .35), intraoperative complications (P = .23), or postoperative complications (P = .49) were observed. Conclusion: Lung isolation through main stem intubation, when compared with bronchial blockers, is associated with shorter operative time, shorter anesthetic exposure, and diminished blood loss in pediatric patients undergoing lobectomy for congenital lung anomalies.
AB - Purpose: Resection of many congenital lung lesions is commonly performed under single-lung ventilation, which helps collapse the lung being manipulated and enables a thoracoscopic approach in most cases. We set out to determine whether lung isolation achieved by either main stem intubation or usage of a bronchial blocker was associated with superior clinical outcomes. Materials and Methods: A retrospective review of all patients aged <2 years undergoing elective pulmonary lobectomy for congenital lung malformations at a tertiary-care pediatric hospital from 2011 through 2020 was performed. Demographic data, diagnosis type, type of lung isolation method employed, and perioperative outcomes were recorded. Continuous variables were analyzed with Student's t-tests, whereas categorical variables were analyzed with Fisher's exact tests and chi-square tests. Results: Thirty-two patients were analyzed - 17 were managed with a bronchial blocker while 15 underwent main stem intubation. The most common diagnoses were congenital pulmonary airway malformations (53.1%) and intralobar bronchopulmonary sequestrations (34.4%). Patients managed with main stem intubation were slightly younger (P = .06) than those for which a bronchial blocker was used. Thirty-one (96.9%) resections were initiated thoracoscopically. Main stem intubation was associated with shorter operative times (P = .01), shorter anesthetic times (P = .02), and less blood loss (P = .04). No differences in length of stay (P = .64), conversation to thoracotomy (P = .35), intraoperative complications (P = .23), or postoperative complications (P = .49) were observed. Conclusion: Lung isolation through main stem intubation, when compared with bronchial blockers, is associated with shorter operative time, shorter anesthetic exposure, and diminished blood loss in pediatric patients undergoing lobectomy for congenital lung anomalies.
KW - bronchial blocker
KW - congenital lung anomalies
KW - endobronchial intubation
KW - pediatric pulmonary lobectomy
UR - http://www.scopus.com/inward/record.url?scp=85133708123&partnerID=8YFLogxK
U2 - 10.1089/lap.2021.0741
DO - 10.1089/lap.2021.0741
M3 - Article
C2 - 35394363
AN - SCOPUS:85133708123
SN - 1092-6429
VL - 32
SP - 800
EP - 804
JO - Journal of Laparoendoscopic and Advanced Surgical Techniques
JF - Journal of Laparoendoscopic and Advanced Surgical Techniques
IS - 7
ER -