Clinical Value of a Novel Visual Laryngeal Mask Airway in Thoracoscopic Lung Resection: A Single-Center Randomized Controlled Trial

Objective:This study aimed to assess the clinical outcomes of three lung isolation techniques inthoracic surgery: video-assisted double-lumen tube (VDLT), bronchial blocker (BO), and their combined use. The primary outcomes were peak airway pressure, lung ventilation time, hemodynamic parameters, and postoperative recovery, providing evidence to guide the optimal selection of lung isolation methods for clinical practice.Methods:A prospective randomized controlled trial was conducted from May 2020 to May 2024, involving 135 patients scheduled for thoracic surgery. Patients were randomly assigned into three groups: VDLT group (n=45), BO group (n=45), and VDLT+BO combined group (n=45). Key parameters, including peak airway pressure, positioning time, ventilation time, hemodynamic data, and postoperative recovery outcomes, were closely monitored. Statistical analyses, including t-tests, ANOVA, and multivariate regression, were used to assess the impact of each lung isolation method on arterial oxygen partial pressure (PaO₂) and postoperative pneumonia risk.Results:The combined VDLT+BO approach demonstrated significant advantages over the single-device techniques. It lowered peak airway pressure (22.61±1.49 mmHg vs. 27.11±1.66 mmHg, P<0.001), reduced positioning time (3.98±1.03 minutes vs. 7.18±1.27 minutes, P<0.001), and improved PaO₂ (4.70 mmHg, P<0.001). Furthermore, the VDLT+BO group exhibited a significantly lower incidence of postoperative pneumonia (8.9% vs. 24.4%, P=0.050). This approach also reduced postoperative pain scores (3.73±0.93), shortened hospital stay (4.24±1.07 days), and decreased hospitalization costs by 27.4%. Multivariate analysis identified positioning time and BMI as key factors influencing the incidence of postoperative pneumonia.Conclusion:The VDLT+BO combined approach effectively enhances lung isolation during thoracic surgery by reducing airway injury risk, improving oxygenation, and accelerating postoperative recovery, while also lowering medical costs. This combination offers a more efficient alternative to traditional methods and should be considered for broader clinical application. Future studies should examine its adaptability in different surgical contexts and explore its long-term clinical effects.