"Selective bronchus-blowing" method for effective inflate-deflate line identification in lung segmentectomy

Area of Science:

• Thoracic Surgery
• Pulmonary Medicine
• Surgical Techniques

Background:

• Intraoperative selective bronchial air delivery is crucial for identifying target lung segments during pulmonary resections.
• Comparing different ventilation methods is essential for optimizing surgical safety and efficacy.

Purpose of the Study:

• To compare the effectiveness of high-frequency jet ventilation (HFJV) and the bronchus-blowing method for intraoperative selective bronchial air delivery.
• To evaluate the visualization of lung segments and surgical outcomes associated with each method.

Main Methods:

• A prospective study involving 86 patients undergoing lung resection with selective bronchus-blowing.
• Two ventilation methods were assessed: high-frequency jet ventilation (HFJV) and a 20G cannula-based bronchus-blowing method.
• Classification of the inflate-deflate line (clear, slightly clear, unclear) and assessment of surgical factors were performed.

Main Results:

• The bronchus-blowing group had a higher incidence of complex segmentectomies and significantly better inflate-deflate line identification (P=0.02) compared to the HFJV group.
• Complete resection rates were higher in the bronchus-blowing group (90.3%) versus the HFJV group (73.5%).
• Higher rates of unsuccessful surgery were observed in patients with severe emphysema, interstitial pneumonia, and anthracosis.

Conclusions:

• The bronchus-blowing method facilitates effective visualization of lung segments during surgery.
• This technique supports safe identification of target lung segments, potentially improving surgical outcomes in lung resections.