One-lung ventilation and right-sided double-lumen tubes: a national survey of current practice in Japan

One-lung ventilation (OLV) is an essential technique in thoracic surgery, and double-lumen endobronchial tubes (DLTs) are commonly used. While right-sided DLTs are useful in specific situations, few studies have investigated the prevalence of their use. This study aimed to investigate the current practice of OLV and right-sided DLT usage among anesthesiologists in Japan.

A nationwide cross-sectional survey was conducted in September 2024, targeting 1444 hospitals certified by the Japanese Society of Anesthesiologists. Questionnaires were mailed to anesthesiology departments, inquiring about OLV practices, right-sided DLT usage, challenges, and desired improvements. Responses were collected via postal mail or web, and data were analyzed using descriptive statistics and Chi-square tests.

A total of 768 institutions responded (response rate: 53.2%). Among 761 valid responses, 74.9% performed OLV, and DLTs were the most frequently used device (94.7%). Approximately half (45.8%) of the institutions performing OLV reported never using right-sided DLTs. Frequently recognized challenges included insertion difficulty, positioning difficulty, and unfamiliarity, and 42.1% of institutions expressed a willingness to increase the use of right-sided DLTs if these challenges were resolved. Institutions with a higher annual volume of OLV cases tended to use right-sided DLTs more frequently, but the proportion of institutions unfamiliar with right-sided DLTs was not associated with the number of OLV cases performed.

OLV is widely practiced in Japan, primarily using DLTs, while the use of right-sided DLTs is limited. Concerns over technical difficulties and complications may hinder the use of right-sided DLTs.