GKD Anest Yoð Bak Dern Derg. 2014; 20(3): 149-153 | DOI: 10.5222/GKDAD.2014.149

Çift Lümenli Endotrakeal Tüp Pozisyonunun Doðrulanmasýnda Fiberoptik Bronkoskop Ýle Kablosuz Video Endoskopun (Disposkope®) Karþýlaþtýrýlmasý

Hasan Mehmet Kamburoðlu¹, Gökhan Özkan², Tarýk Purtuloðlu², Abdülkadir Atým², Memduh Yetim², Mehmet Emin Ýnce², Vedat Yýldýrým², Ercan Kurt^2
1Erzincan Asker Hastanesi Anesteziyoloji Kliniði, Erzincan, Türkiye
²Gülhane Askeri Týp Akademisi Anesteziyoloji Anabilim Dalý, Ankara, Türkiye

AMAÇ: Toraks cerrahisinde tek akciðer ventilasyonunu saðlamak amacýyla yerleþtirilen çift lümenli endotrakeal tüpün pozisyonu çeþitli yöntemlerle doðrulanabilmektedir. Biz bu çalýþmamýzda toraks cerrahisi yapýlacak olan hastalara yerleþtirilen çift lümenli endotrakeal tüpün yerinin doðrulanmasýnda altýn standart olan fiberoptik bronkoskop ile kablosuz video endoskopun; görüntüleme baþarýsý ve hýzý ile hastanýn cerrahiye verilme süreleri açýsýndan karþýlaþtýrmayý amaçladýk.
YÖNTEMLER: Etik kurul onayý sonrasý çalýþmaya elektif koþullarda çift lümenli endotrakeal tüp yerleþtirme endikasyonu olan, toraks cerrahisi uygulanacak 40 hasta alýndý. Entübasyon sonrasý tüplerin yeri konvansiyonel yöntemlerle deðerlendirildi ve doðru pozisyon verildi. Hastalar randomize olarak iki gruba ayrýldý, çift lümenli endotrakeal tüplerin pozisyonlarý kablosuz video endoskop (Grup I, n=20) ve fiber optik (Grup II, n=20) ile tekrar deðerlendirilip, görüntüleme süreleri ile hastalarýn cerrahiye verilme süreleri kaydedildi.
BULGULAR: Yerleþim yerinin tespiti açýsýndan gruplar arasýnda anlamlý fark yoktu. Grup I’de 3 (%15) hastada, Grup II’de 7 (%35) hastada yanlýþ yerleþim tespit edilerek düzeltildi. Görüntüleme süreleri Grup I’de 18 sn, Grup II’de 131 sn (p< 0.05); hastalarýn cerrahiye verilme süreleri ise Grup I’de 468 sn, Grup II’de 690 sn olarak bulundu (p< 0.05).
SONUÇ: Sonuç olarak çalýþmamýzda toraks cerrahisinde çift lümenli endotrakeal tüp yerinin doðrulanmasýnda her iki yöntemin de etkin olduðu görülmüþtür. Bununla birlikte tüp yerinin doðrulanmasý iþleminin ve cerrahinin baþlatýlmasýnýn kablosuz video endoskop ile daha kýsa sürede yapýlabileceði kanaatine vardýk.

Anahtar Kelimeler: Torasik Cerrahi, Fleksibl Fiberoptik Bronkoskopi, Çift Lümenli Tüp, Tek Akciðer Ventilasyonu, Endoskop

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Comparison Of The Efficacy Of Fiberoptic Bronchoscopy And Wireless Video Endoscope (Disposkope®) In Confirmation Of The Position Of Double Lumen Endotracheal Tube

Hasan Mehmet Kamburoðlu¹, Gökhan Özkan², Tarýk Purtuloðlu², Abdülkadir Atým², Memduh Yetim², Mehmet Emin Ýnce², Vedat Yýldýrým², Ercan Kurt^2
1Erzincam Military Hospital, Departmnt Of Anesthesiology, Erzincan, Turkey
²Gülhane Military Medical Academy, Deparment Of Anesthesiology And Reanimation, Ankara, Turkey

OBJECTIVE: In thoracic surgery, the position of double–lumen endotraceal tube placed in order to provide one-lung ventilation can be confirmed by various methods. In this study, we aimed to compare the groups undergoing thoracic surgery with fiberoptic bronchoscope or wireless video endoscope in confirmation of the position of double–lumen endotraceal tube with regard to success and duration of visualisation and the time until the begining of surgery.
METHODS: After ethical committe approval, forthy voluntary patients undergoing thoracic surgery with double–lumen endotraceal tube were included in to the study. After intubation, the location of the double–lumen endotraceal tubes were evaluated by conventional methods and were given the correct position. The patients were randomly divided in two groups as video endoscope (Group I, n=20) and fiberoptic bronchoscope (Group II, n=20) groups. Afterwards, duration of visualisation and the time until the begining of surgery were recorded in both groups.
RESULTS: There wasn’t statistically significant difference between two groups in confirmation of double–lumen endotraceal tube’s position. Malposition of double–lumen endotraceal tube was detected and fixed in three patients (15%) of group I and in seven (35%) of group II. Visualisation times were 18 sec in group I and 131 sec in group II (p< 0.05); and the times until the begining of surgery were 468 sec in group I and 690 sec in group II (p< 0.05).
CONCLUSION: As a result, it’seen that both methods were effective in the confirmation of double–lumen endotraceal tube’s position in thoracic surgery. Apart from that, in confirmation of double–lumen endotraceal tube’s position and earlier administiration to surgery, we concluded that wireless video endoscope may have shorter evaluation time.

Keywords: Thoracic Surgery, flexible fiberoptic bronchoscopy, Double-lumen tube, One-lung ventilation, Endoscope

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ATIF KOPYALA