Successful Double-lumen Tube Intubation in the Lateral Position for a Patient with a Giant Superior Mediastinal Tumor.

OBJECTIVE: Anesthetic management of patients with giant mediastinal tumors is challenging from the perspective of both cardiovascular and respiratory management, and airway assessment is important for both concerns. We report the successful induction of general anesthesia and double-lumen tube intubation in the right lateral position for a patient with a giant mediastinal tumor with tracheal compression, using pre-operative chest radiograph imaging to minimize tracheal compression during induction.

METHODS: A 41-year-old man required thoracoscopic giant superior mediastinal tumor resection. His trachea was compressed and displaced because of the tumor. Because preoperative chest radiography revealed that the tracheal diameter increased in the right lateral position, we chose this position for induction.

RESULTS: Prompt and smooth intubation with a 35-Fr double-lumen tube (DLT) was achieved, and no adverse events associated with intubation were encountered.

CONCLUSION: Safe and smooth induction with a DLT was performed owing to the perioperative chest radiograph imaging examination, which revealed the most advantageous position regarding minimal tracheal compression.