• Yang Gu, Ruowang Duan, Xin Lv, and Jiong Song.
• The Department of Anesthesiology, Tongji University Affiliated Shanghai Pulmonary Hospital, 507 Zhengmin Rd, Shanghai, China.
• BMC Anesthesiol. 2019 May 20; 19 (1): 82.

BackgroundLung resection after previous contralateral pneumonectomy is rare. We present a case of right anterior segmentectomy despite previous left pneumonectomy, demanding special airway management strategy.Case PresentationA 48-year-old woman who had left pneumonectomy 2 years ago was scheduled to have the right anterior segmentectomy through uniportal video-assisted thoracoscopy (VATS). A 32-French (Fr) left-sided double-lumen endobronchial tube (DLT) was chosen and adapted. The DLT was intubated into the bronchus intermedius. And the upper lobe can be isolated from the ventilation in the middle and lower lobes when the bronchial cuff's inflated. The perioperative period was uneventful and the pathological diagnosis was adenocarcinoma.ConclusionLung cancer radical resection was discouraged after previous contralateral pneumonectomy partly due to the challenging ventilation and isolation. With this new DLT adapting and intubation technique showed in this case, the challenging ventilation and isolation that deter the implementation of the operation mentioned above could be solved.

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