Predictors of failure of intersegmental line creation using bronchoscopic jet ventilation for thoracoscopic pulmonary segmentectomy

Mizuko Ikeda; Miwako Tanabe; Ayumi Fujimoto; Tomoka Matsuoka; Makoto Sumie; Ken Yamaura

doi:10.1186/s40981-021-00457-5

Predictors of failure of intersegmental line creation using bronchoscopic jet ventilation for thoracoscopic pulmonary segmentectomy

JA Clin Rep. 2021 Jul 6;7(1):53. doi: 10.1186/s40981-021-00457-5.

Authors

Mizuko Ikeda^{1

2}, Miwako Tanabe^{3

4}, Ayumi Fujimoto³, Tomoka Matsuoka³, Makoto Sumie⁵, Ken Yamaura⁶

Affiliations

¹ Department of Anesthesiology, Federation of National Public Service Personnel Mutual Aid Associations, Fukuoka, Japan. ikedam@college.fdcnet.ac.jp.
² Present Address: Section of Anesthesiology, Department of Diagnostics and General Care, Fukuoka Dental College, 2-15-1, Tamura, Sawara-ku, Fukuoka, Fukuoka, 814-0193, Japan. ikedam@college.fdcnet.ac.jp.
³ Department of Anesthesiology, Federation of National Public Service Personnel Mutual Aid Associations, Fukuoka, Japan.
⁴ Present Address: Department of Anesthesiology, St. Mary's Hospital, Fukuoka, Japan.
⁵ Department of Anesthesiology and Critical Care Medicine, Kyushu University Hospital, Fukuoka, Japan.
⁶ Department of Anesthesiology and Critical Care Medicine, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan.

Abstract

Background: During pulmonary segmentectomy, identification of the target segment is essential. We used bronchoscopic jet ventilation (BJV) to delineate the intersegmental plane by selectively sending air into the target segment. The purpose of this study was to investigate the factors associated with BJV failure.

Methods: Data were retrospectively collected from 48 patients who underwent pulmonary segmentectomy with BJV between March 2014 and May 2019 at a single center. Data were compared between BJV succeeded cases and failed cases.

Results: In 13 cases (27%), BJV were unsuccessful. The Brinkman index was significantly higher in failed cases (962 ± 965 failed vs. 395 ± 415 successful, P = 0.0067). The success rate was significantly lower when BJV was applied to the posterior basal segmental bronchus (B10) (B10: 1/5 (20%) vs others: 34/43 (79%), P = 0.015).

Conclusion: Long-term smoking and the bronchus corresponding to the posterior basal segment might make successful performance of BJV difficult.

Keywords: Broncoscopy; Jet ventilation; Pulmonary segmentectomy; Thoracoscopic surgery.