Abstract
Lung isolation is a critical aspect of patient management during thoracic cancer surgeries. While conventional techniques are well established for patients with normal airway anatomy, anatomical alterations in the upper or lower airways, especially due to cancer, can pose significant challenges. This review thoroughly examines the available lung isolation techniques for challenging airway scenarios, aiming to guide clinicians in selecting the most appropriate approach for each patient. Here, we explore the intricacies and nuances of one-lung ventilation in patients with altered airway anatomy. A comprehensive literature search was conducted using PubMed from January 2000 to May 2024, and additional references were identified through manual review. A tailored approach using available techniques is warranted in difficult airway scenarios, especially in patients with complex anatomical variations. The techniques such as a single-lumen endotracheal tube with bronchial blocker and a double-lumen tube insertion using a video laryngoscope or paediatric fibre-optic bronchoscope are discussed in difficult upper airway abnormalities. In some of the lower airway abnormalities, diverse lung isolation techniques mentioned in the literature are described.
Published Version
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