MAN-LING WANGYI-PING WANGMING-HUI HUNGHSAO-HSUN HSUJIN-SHING CHENYang, Fu-SuiFu-SuiYangYA-JUNG CHENG2019-11-182019-11-182018-01-0110107940https://scholars.lib.ntu.edu.tw/handle/123456789/431396© The Author 2017. OBJECTIVES: To determine the success rate of blind insertion and the usefulness of fibre-optic bronchoscopy for directing rigid-angled endobronchial blockers (EBs) to the correct side and achieving satisfactory surgical fields. METHODS: A randomized trial was designed to determine the extent to which the Coopdech Endobronchial Blocker Tube (Daiken Medical Co., Ltd) could successfully be placed through either auscultation (n = 57) or fibre-optic bronchoscopy (n = 55) in patients scheduled for thoracic surgery. The placement time was recorded and quality of the thoracoscopic operation field was determined by the thoracic surgeon. Anaesthesiologists with varying thoracic experience levels were enrolled. RESULTS: The success rates of insertion through auscultation were 100% (32 of 32) for the right side and 88% (22 of 25) for the left side. Placement through auscultation was faster than that through bronchoscopy (mean 89.6 vs 141.1 s, P = 0.008) in the right-sided procedure but non-significant in the left-sided procedure (mean 138.5 vs 130 s, P = 0.795). Surgical grading of the operation field was not significantly different between both techniques (P = 0.502). Experienced anaesthesiologists took less time to position EBs (mean 91.0 vs 138.0 s, P = 0.015). Surgical grading was comparable between specialists and residents (P = 0.058). CONCLUSIONS: Once an EB was correctly inserted and confirmed through auscultation, the corresponding surgical satisfaction was comparable to that through bronchoscopy. In the majority of cases, bronchoscopy is unnecessary for correct and efficient EB positioning. However, bronchoscopy is still mandatory in left-sided EB insertion and in patients with deviated tracheobronchial anatomy.Fibre-optic bronchoscopy | Intubation | Lung separation devices | Thoracoscopy/video-assisted thoracoscopic surgeryFibre-optic bronchoscopy; Intubation; Lung separation devices; Thoracoscopy/video-assisted thoracoscopic surgery[SDGs]SDG3adult; anesthesiologist; Article; auscultation; controlled study; esophagus surgery; female; fiberoptic bronchoscopy; human; intermethod comparison; lobectomy; lung wedge resection; major clinical study; male; mediastinal mass resection; mediastinal tumor resection; priority journal; randomized controlled trial; satisfaction; segmentectomy; sternotomy; surgical technique; Taiwan; thoracic surgeon; thoracotomy; thorax surgery; aged; bronchoscopy; devices; middle aged; outcome assessment; procedures; thorax surgery; Adult; Aged; Auscultation; Bronchoscopy; Female; Humans; Male; Middle Aged; Outcome Assessment (Health Care); Thoracic Surgical Proceduresjournal article10.1093/EJCTS/EZX260289503802-s2.0-85045960122https://api.elsevier.com/content/abstract/scopus_id/85045960122