The Experts below are selected from a list of 84 Experts worldwide ranked by ideXlab platform
Tadasu Kohno - One of the best experts on this subject based on the ideXlab platform.
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imaging aid for thoracic surgery multidetector row computed tomography evaluation of the tracheoBronchial structure and Bronchial Tube selection for one lung anesthesia
The Japanese Journal of Thoracic and Cardiovascular Surgery, 2009Co-Authors: Itsuko Okuda, Hiromi Yamase, Shigeru Ogawa, Harushi Udagawa, Tadasu KohnoAbstract:The tracheoBronchial structures were evaluated by multidetector-row computed tomography (MDCT), which provided imaging information for one-lung anesthesia during thoracic surgery. The subjects consisted of 100 patients. Three-dimensional (3D) images of the tracheoBronchial structures and the Bronchial Tubes were created. Individual differences were found in the tracheoBronchial structures in 100 patients. The length and the diameter of the right main bronchus were measured with 3D images and were not related to the patient’s physical appearance, such as body height. Problematic intubation cases included a short right main bronchus <10 mm, an anomaly of the right bronchus, and tracheal stenosis. The 3D images demonstrated problematic areas of the tracheoBronchial structure and helped the anesthesiologists select the most appropriate Bronchial Tube suitable for the tracheoBronchial structure variations. Therefore, this technique is considered to contribute to safer performance of one-lung anesthesia.
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selection of the Bronchial Tube for one lung anesthesia by multidetector row computed tomography md ct evaluation
Kyobu geka. The Japanese journal of thoracic surgery, 2005Co-Authors: Itsuko Okuda, T Kokubo, Hiromi Yamase, Tadasu Kohno, Y TagayaAbstract:One-lung anesthesia is a method of anesthesia performed by inserting the tip of a Bronchial Tube into either the right main bronchus or the left main bronchus. The right Bronchial Tube is a special structure. Since the distance of the carina to the right upper lobe bronchus is short, a side hole is made to prevent blockading of the right upper lobe bronchus, and the cuff is attached aslant to it. When inserting a Bronchial Tube into the right main bronchus, care is required to prevent the occurrence of atelectasis though a gap in the Bronchial Tube. We evaluated the structure of a trachea and a bronchus using the multidetector-row computed tomography (MD CT), and tried to select the right Bronchial Tube most suitable for each structure. There are individual differences in the structure of a trachea and a bronchus. By creating a 3-dimensional image of a trachea and a bronchus, the structure could be easily grasped, and therefore selection of the most appropriate Bronchial Tube according to the structure was possible.
Jaehyon Bahk - One of the best experts on this subject based on the ideXlab platform.
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misplacement of left sided double lumen Tubes into the right mainstem bronchus incidence risk factors and blind repositioning techniques
BMC Anesthesiology, 2015Co-Authors: Jeonghwa Seo, Jun Yeol Bae, Hyun Joo Kim, Deok Man Hong, Yunseok Jeon, Jaehyon BahkAbstract:Double-lumen endoBronchial Tubes (DLTs) are commonly advanced into the mainstem bronchus either blindly or by fiberoptic bronchoscopic guidance. However, blind advancement may result in misplacement of left-sided DLTs into the right bronchus. Therefore, incidence, risk factors, and blind repositioning techniques for right Bronchial misplacement of left-sided DLTs were investigated. This was an observational cohort study performed on the data depository consecutively collected from patients who underwent intubation of left-sided DLTs for 2 years. Patients’ clinical and anatomical characteristics were analyzed to investigate risk factors for DLT misplacements with logistic regression analysis. Moreover, when DLTs were misplaced into the right bronchus, the Bronchial Tube was withdrawn into the trachea and blindly readvanced without rotation, or with 90° or 180° counterclockwise rotation while the patient’s head was turned right. DLTs were inadvertently advanced into the right bronchus in 48 of 1135 (4.2 %) patients. DLT misplacements occurred more frequently in females, in patients of short stature or with narrow trachea and bronchi, and when small-sized DLTs were used. All of these factors were significantly inter-correlated each other (P < 0.001). In 40 of the 48 (83.3 %) patients, blind repositioning was successful. Smaller left-sided DLTs were more frequently misplaced into the right mainstem bronchus than larger DLTs. Moreover, we were usually able to reposition the misplaced DLTs into the left bronchus by using the blind techniques. ClinicalTrials.gov Identifier: NCT01371773 .
Bahk Jae-hyon - One of the best experts on this subject based on the ideXlab platform.
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Misplacement of left-sided double-lumen Tubes into the right mainstem bronchus: incidence, risk factors and blind repositioning techniques
BioMed Central, 2017Co-Authors: Seo Jeong-hwa, Bae Jun-yeol, Kim, Hyun Joo, Hong, Deok Man, Jeon Yunseok, Bahk Jae-hyonAbstract:This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.Abstract Background Double-lumen endoBronchial Tubes (DLTs) are commonly advanced into the mainstem bronchus either blindly or by fiberoptic bronchoscopic guidance. However, blind advancement may result in misplacement of left-sided DLTs into the right bronchus. Therefore, incidence, risk factors, and blind repositioning techniques for right Bronchial misplacement of left-sided DLTs were investigated. Methods This was an observational cohort study performed on the data depository consecutively collected from patients who underwent intubation of left-sided DLTs for 2 years. Patients’ clinical and anatomical characteristics were analyzed to investigate risk factors for DLT misplacements with logistic regression analysis. Moreover, when DLTs were misplaced into the right bronchus, the Bronchial Tube was withdrawn into the trachea and blindly readvanced without rotation, or with 90° or 180° counterclockwise rotation while the patient’s head was turned right. Results DLTs were inadvertently advanced into the right bronchus in 48 of 1135 (4.2 %) patients. DLT misplacements occurred more frequently in females, in patients of short stature or with narrow trachea and bronchi, and when small-sized DLTs were used. All of these factors were significantly inter-correlated each other (P
Itsuko Okuda - One of the best experts on this subject based on the ideXlab platform.
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imaging aid for thoracic surgery multidetector row computed tomography evaluation of the tracheoBronchial structure and Bronchial Tube selection for one lung anesthesia
The Japanese Journal of Thoracic and Cardiovascular Surgery, 2009Co-Authors: Itsuko Okuda, Hiromi Yamase, Shigeru Ogawa, Harushi Udagawa, Tadasu KohnoAbstract:The tracheoBronchial structures were evaluated by multidetector-row computed tomography (MDCT), which provided imaging information for one-lung anesthesia during thoracic surgery. The subjects consisted of 100 patients. Three-dimensional (3D) images of the tracheoBronchial structures and the Bronchial Tubes were created. Individual differences were found in the tracheoBronchial structures in 100 patients. The length and the diameter of the right main bronchus were measured with 3D images and were not related to the patient’s physical appearance, such as body height. Problematic intubation cases included a short right main bronchus <10 mm, an anomaly of the right bronchus, and tracheal stenosis. The 3D images demonstrated problematic areas of the tracheoBronchial structure and helped the anesthesiologists select the most appropriate Bronchial Tube suitable for the tracheoBronchial structure variations. Therefore, this technique is considered to contribute to safer performance of one-lung anesthesia.
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selection of the Bronchial Tube for one lung anesthesia by multidetector row computed tomography md ct evaluation
Kyobu geka. The Japanese journal of thoracic surgery, 2005Co-Authors: Itsuko Okuda, T Kokubo, Hiromi Yamase, Tadasu Kohno, Y TagayaAbstract:One-lung anesthesia is a method of anesthesia performed by inserting the tip of a Bronchial Tube into either the right main bronchus or the left main bronchus. The right Bronchial Tube is a special structure. Since the distance of the carina to the right upper lobe bronchus is short, a side hole is made to prevent blockading of the right upper lobe bronchus, and the cuff is attached aslant to it. When inserting a Bronchial Tube into the right main bronchus, care is required to prevent the occurrence of atelectasis though a gap in the Bronchial Tube. We evaluated the structure of a trachea and a bronchus using the multidetector-row computed tomography (MD CT), and tried to select the right Bronchial Tube most suitable for each structure. There are individual differences in the structure of a trachea and a bronchus. By creating a 3-dimensional image of a trachea and a bronchus, the structure could be easily grasped, and therefore selection of the most appropriate Bronchial Tube according to the structure was possible.
Zhong Hua Chen - One of the best experts on this subject based on the ideXlab platform.
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iatrogenic rupture of the left main bronchus secondary to repeated surgical lobe torsion during double lumen Tube placement a case report
Medicine, 2017Co-Authors: Zong Ming Jiang, Chu Zhang, Zhong Hua ChenAbstract:Rationale Bronchial rupture is a rare but potentially life-threatening complication during double-lumen endoBronchial Tube placement. The rupture of the left main bronchus resulting from repeated surgical torsion is uncommon. Patient concerns A 70-year-old man with a history of chronic obstructive pulmonary disease (COPD), intermediate emphysema, chronic bronchitis, hypertension, type 2 diabetes mellitus, and L3-L4 lumbar intervertebral disc herniation. Chest x-ray and computed tomography revealed a solitary pulmonary nodule in the left lower lobe. Diagnoses Left lower lobe carcinoma. Interventions To improve surgical access, forceps were used to oppress and torque the left lung. Outcomes An irregular, circular, horizontal, full-thickness rupture of 1.2 cm was observed at the tip of the Bronchial Tube in the left main bronchus upon examination of the Bronchial stump.The rupture was repaired via primary suturing with 4-0 prolene thread and secondary reinforcement with a pericardial flap through a left thoracotomy, with no further complications. Lessons Caution should be exercised during compression and torsion of the pulmonary lobe when attempting to improve surgical access, especially in patients with COPD. Conversion to thoracotomy is recommended if other measures have been unsuccessful.
