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Purpose <p>Laryngeal tumors can cause significant anatomical distortion, making tracheal intubation challenging. Compared to video laryngoscope (VL), intubation using a Disposcope endoscope (DE) offers flexibility and allows for better navigation around obstructive lesions in the upper airway. This study aimed to compare the clinical performance of DE and VL for anticipated laryngeal tumor related difficult intubation in Ear, Nose, and Throat (ENT) patients undergoing general anesthesia.</p> Methods <p>We conducted a prospective, randomized, controlled trial. Eighty patients with anticipated difficult intubation due to laryngeal tumors undergoing elective surgery were included and randomly allocated to either the DE group (<i>n</i> = 40) or the VL group (<i>n</i> = 40). The primary outcome was the first-attempt success rate of tracheal intubation. Secondary outcomes included intubation time, hemodynamic response, and the incidence of complications related to intubation.</p> Results <p>A total of 80 subjects (61 male/19 female, 30 to 81 years old) were included in the final analysis. The first-attempt success rate of tracheal intubation was significantly higher in the DE group compared with the VL group (97.5% vs. 77.5%; mean difference [95% CI]: 20% [5.5 to 35.1]; <i>P</i> = 0.007). The intubation time was reduced in the DE group compared to the VL group (28.5 ± 6.7&#xa0;s vs. 39.0 ± 10.0&#xa0;s, mean difference [95% CI]: 10.5&#xa0;s [6.7 to 14.3]; <i>P</i> &lt; 0.001). Compared to DE, VL exhibited a higher heart rate one minute after intubation (71.1 ± 10.9 bpm vs. 78.3 ± 12.8&#xa0;bpm; mean difference [95% CI]: 7.2&#xa0;bpm [1.9 to 12.5]; <i>P</i> = 0.008). The incidence of postoperative airway complications was not significantly different between the two groups.</p> Conclusion <p>The DE showed a higher first-attempt success rate and a shorter intubation time than the VL for anticipated laryngeal tumor related difficult intubation in ENT patients undergoing general anesthesia.</p> Trial registration <p>Chinese Clinical Trials Identifier ChiCTR2300068449.</p>

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Video laryngoscope versus disposcope endoscope for anticipated laryngeal tumor related difficult intubation in patients undergoing general anesthesia: a randomized controlled trial

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年12月26日

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  • Hongyan Xiao,
  • Yanan Xiao,
  • Lili Feng,
  • Yilei Shen,
  • Liu Han,
  • Yingjie Wang,
  • Yirong Cai,
  • Ji’e Jia,
  • Peixia Wu,
  • Yuan Han,
  • Wenxian Li

摘要

Purpose

Laryngeal tumors can cause significant anatomical distortion, making tracheal intubation challenging. Compared to video laryngoscope (VL), intubation using a Disposcope endoscope (DE) offers flexibility and allows for better navigation around obstructive lesions in the upper airway. This study aimed to compare the clinical performance of DE and VL for anticipated laryngeal tumor related difficult intubation in Ear, Nose, and Throat (ENT) patients undergoing general anesthesia.

Methods

We conducted a prospective, randomized, controlled trial. Eighty patients with anticipated difficult intubation due to laryngeal tumors undergoing elective surgery were included and randomly allocated to either the DE group (n = 40) or the VL group (n = 40). The primary outcome was the first-attempt success rate of tracheal intubation. Secondary outcomes included intubation time, hemodynamic response, and the incidence of complications related to intubation.

Results

A total of 80 subjects (61 male/19 female, 30 to 81 years old) were included in the final analysis. The first-attempt success rate of tracheal intubation was significantly higher in the DE group compared with the VL group (97.5% vs. 77.5%; mean difference [95% CI]: 20% [5.5 to 35.1]; P = 0.007). The intubation time was reduced in the DE group compared to the VL group (28.5 ± 6.7 s vs. 39.0 ± 10.0 s, mean difference [95% CI]: 10.5 s [6.7 to 14.3]; P < 0.001). Compared to DE, VL exhibited a higher heart rate one minute after intubation (71.1 ± 10.9 bpm vs. 78.3 ± 12.8 bpm; mean difference [95% CI]: 7.2 bpm [1.9 to 12.5]; P = 0.008). The incidence of postoperative airway complications was not significantly different between the two groups.

Conclusion

The DE showed a higher first-attempt success rate and a shorter intubation time than the VL for anticipated laryngeal tumor related difficult intubation in ENT patients undergoing general anesthesia.

Trial registration

Chinese Clinical Trials Identifier ChiCTR2300068449.