Double-lumen tube insertion using flexible fiberoptic bronchoscope compared with conventional blind technique in esophageal cancer patients: a randomized controlled study

Abstract

Background Double-lumen tube (DLT) is usually performed using blind placement followed by bronchoscopic position confirmation, which is time consuming and complications may occur. We assume that bronchoscopic-guided DLT placement and position confirmation will save time and complications may be less. Patients and methods A total of 31 patients included in this study were randomly allocated into either the conventional group ( n = 15) or the bronchoscopic group ( n = 16) on the basis of DLT placement; in the conventional group the DLT was inserted blindly, whereas in the bronchoscopic group the DLT was inserted under guidance of the flexible bronchoscopy passed into the bronchial lumen. Thereafter, clinical assessment was performed followed by bronchoscopic assessment in both groups. Clinical findings and bronchoscopic assessment as well as time needed for each were recorded. Hemodynamic response, oxygen saturation, and arrhythmias were also recorded. Results Both groups were comparable with respect to demographic data. There was significant difference when comparing time needed for placement and confirmation of DLT in both groups. The clinical assessment was satisfactory in 12 as against 16 patients, whereas the bronchoscopic assessment revealed proper positioning in seven as against 13 patients and misplacement in eight as against three patients in the conventional and bronchoscopic groups, respectively. Hemodynamic response, oxygen saturation, and arrhythmias did not show any differences. Conclusion Flexible fiberoptic bronchoscopy could be used safely as an initial guide for placement and position confirmation; time needed for placement and confirmation as well as complications were reduced.