Efficacy of laryngeal mask airway versus endotracheal tube during total minimally invasive oesophagectomy: a randomized controlled trial

Abstract

This study aimed to assess the feasibility and efficacy of a laryngeal mask airway (LMA) compared with a single-lumen tube (SLT) in total minimally invasive oesophagectomy (MIE). Adult patients who underwent MIE were randomly assigned to either group using an LMA (n = 45) or an SLT (n = 45). The primary outcome was the incidence of postoperative pneumonia. Eighty-seven patients completed the study protocol. There were no significant differences in the incidence of postoperative pneumonia (33% vs. 38%; p = 0.665). The incidence of sore throat 2 h after the operation was lower in the LMA group than in the SLT group (10% vs. 27%; p = 0.039). The LMA group had lower pain scores at 2 h (2[2-3] vs. 3[2-4]; p = 0.035) and 1 day (1.5[1-2] vs. 2[1-3]; p = 0.047) after the operation. Compared with the SLT group, the LMA group had a shorter extubation time (16 [15-18] min vs. 18 [17-23.5] min; p < 0.001) and fewer days with gastric tube indwelling (3 [3-5.5] vs. 5 [3-7]; p = 0.011). Nausea and vomiting, hoarseness, delirium, pulmonary aspiration, pleural effusion, anastomotic leakage and postoperative hospital stay did not differ between the two groups. The application of LMA in patients who underwent total MIE enhanced postoperative comfort without increasing the incidence of pulmonary complications. LMA could be a feasible and safe technique for patients with oesophageal cancer.

Keywords: Endotracheal intubation; Laryngeal mask airway; Minimally invasive oesophagectomy; Postoperative pneumonia.

Fig. 1

Flow chart of clinical trial.