Left Main Bronchial Rupture due to False Overinflation of the Double-lumen Tube Cuff

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  • ダブルルーメンチューブカフの大量誤注入による左主気管支膜様部破裂の1手術例

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Background. Tracheal intubation may rarely cause serious complications, such as tracheobronchial rupture. Case. An 82-year-old woman was scheduled to undergo partial resection of pulmonary metastasis from colon cancer. The patient was intubated with a left-sided double-lumen tube to establish separate ventilation. The anesthesia assistant mistakenly overinflated the cuff for the bronchus. As a result, the left main bronchus membrane ruptured. Results. The patient was reintubated with a right-sided double-lumen tube. Under separate ventilation for the left lung while maintaining the least possible airway pressure, a repair operation was performed through right thoracotomy. Separate ventilation for the left lung was not adequate after the mediastinum pleura was incised, thus the right lung was ventilated intermittently during the operation. The ruptured bronchus membrane, which measured approximately 2 cm longitudinally, was sutured, covered with an intercostal muscle flap, and then sprayed with fibrin glue. The pulmonary metastasis was resected using a stapler. After the operation, the patient suffered a wound infection, but it was successfully treated without any major problems, and she was thereafter discharged from the hospital. Conclusions. It is necessary for surgeons to be aware of how to prevent and effectively manage the occurrence of a tracheobronchial rupture.

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