Related Experiment Video
Updated: Apr 2, 2026
Author Spotlight: A Non-Intubated Video-Assisted Thoracoscopic Surgery with Multimodal Analgesia and Sevoflurane Inhalation Anesthesia
Published on: May 26, 2023
Laryngeal mask airway versus endotracheal tube for preventing postoperative atelectasis after laparoscopic surgery: a
Qirui Lu1, Zixuan Zhang1, Xiaomei Sun1
1First Clinical Medical College, Lanzhou University, Lanzhou, China.
Background:
Postoperative atelectasis is a common and clinically significant complication of general anesthesia, particularly during laparoscopic surgery due to reduced lung compliance and diaphragmatic elevation. In this study, the effects of a laryngeal mask airway (LMA) and endotracheal tube (ETT) on postoperative atelectasis after laparoscopic surgery were compared, and a predictive model for lung injury was developed. We hypothesized that the use of a laryngeal mask airway would be associated with reduced postoperative atelectasis compared with endotracheal intubation in patients undergoing laparoscopic surgery.
Methods:
In this single-center, assessor-blinded randomized controlled trial (ChiCTR2400094097), 192 adults (American Society of Anesthesiologists physical status I-III) undergoing elective laparoscopy (gastrointestinal, biliary, hernia, or gynecologic procedures) were randomized to LMA (n = 96) or ETT (n = 96) groups. All patients received lung-protective ventilation. Intraoperative respiratory mechanics (dynamic compliance and peak pressure) were monitored. Lung ultrasound (LUS) of 12 zones was performed preoperatively and 10 min after extubation by blinded investigators. An XGBoost model with SHAP identified predictors of LUS deterioration. The primary outcome was the LUS score (preoperative and 10 min postextubation).
Results:
In total, 186 patients completed follow-up. The ETT group showed significantly higher postoperative LUS scores compared with the LMA group (8.1 ± 1.9 vs. 5.6 ± 2.4, P < 0.001) as well as higher pulmonary complication rates (14% vs. 5.4%, P = 0.047). Airway complications, such as sore throat, were less frequent with LMA use. The XGBoost-SHAP model identified the intraoperative dynamic compliance decay rate as the strongest predictor of LUS deterioration.
Conclusions:
In laparoscopic surgery, laryngeal mask airway use is associated with reduced postoperative atelectasis and pulmonary complications compared with endotracheal intubation. Intraoperative deterioration in lung compliance may serve as an early indicator of postoperative lung aeration impairment detected by lung ultrasound.
Clinical Trial Registration:
https://www.chictr.org.cn/showproj.html?proj=254374, Registration number: ChiCTR2400094097.
More Related Videos
Related Concept Videos
01:15Endotracheal Intubation I: Procedure
The ET tube comprises various components, including a standard adaptor to attach a bag-valve-mask (BVM) or ventilator, a cuff, a pilot balloon, and radiopaque markings along its length to measure the insertion distance. The tube sizes...
01:30Cardiopulmonary Resuscitation V: Advanced Airway Management Techniques
01:24Endotracheal Tube Extubation
Procedure
Extubation removes the endotracheal tube (ETT) from the patient on mechanical ventilation. It requires a well-coordinated, multidisciplinary approach involving physicians, nurses, respiratory therapists, and other healthcare professionals....
01:22Cardiopulmonary Resuscitation II: ACLS Airway Management
01:28Tracheostomy: Procedure and Tubes
Tracheostomy tubes can be made of semiflexible plastic (polyurethane or silicone), rigid plastic, or metal, and they come in...
01:17Endotracheal Intubation II: Nursing Management
1. Nursing Care of Patients Before Intubation
Before the endotracheal intubation procedure, nurses play an essential role in ensuring the process goes smoothly. The nurses must be familiar with intubation...