Background: Accurate knowledge of the mainstem bronchial lengths is essential in order to prevent malpositioning of the double lumen endobronchial tubes (DLT). It is believed that the lengths of the left and right mainstem bronchi measured by CT are more accurate than those measured using a fiberoptic bronchoscope. This study evaluated the length of the mainstem bronchus using a CT scan in Korean adults.Methods: One hundred twenty patients who underwent a chest CT scan without any anatomical changes due to a mass or inflammation were examined. Airway imaging with a minimum intensity projection of the oblique coronal section using multidetector CT was obtained and the lengths of the left and right mainstem bronchi were measured.Results: The lengths of the left mainstem bronchus of the males and females were 49.2 ± 4.8 mm and 44.6 ± 3.9 mm respectively, and the right mainstem bronchus of the males and females were 21.0 ± 4.8 mm and 18.0 ± 4.0 mm, respectively. There was no linear correlation between the height of the patients and the length of the left and right mainstem bronchi.Conclusions: These results provide reference data to help determine the precise margin of safety using a double lumen endobronchial tube for thoracic surgery.
It is important to treat cancer-related pain in cancer patients to ensure the life quality of the patient, as well as to improve their life span. It has been estimated that at least 5% of cancer patients have pain refractory to medical treatment. Therefore, the need for epidural or intrathecal analgesia with opioids and local anesthetics is indicated if systemic treatment has failed. Intrathecal catheter placement and implantation of the injection port for administration of opioids and local anesthetics may improve pain relief in patients who are unresponsive to epidural routes. Although intrathecal implantation has several complications, similar infection rates have been reported between intrathecal and epidural administration. In addition, intrathecal administration showed better outcomes, including improved pain control, lowered daily doses, and an improvement in the level of drowsiness experienced when compared to epidural administration. We report here a case in which a terminal cancer patient was treated using an intrathecal catheter and subcutaneous port. The patient had cancer-related pain that could not be controlled by epidural opioid administration. Based on the results presented here, we suggest that intrathecal implantation is a feasible long term pain management method for intractable cancer pain patients. (
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