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はじめに
右用ダブルルーメンチューブ(double-lumen tube:DLT)の魅力的なフォルムとたたずまい(図1)には誰もが心くすぐられる。従来,左主気管支を切断するような術式に適応されるが,その症例数は決して多くない。近年の右用DLTの良い適応は,左上葉切除後の左主気管支の上方変位を有する患者の2回目の(右肺)手術である。しかしこれらを合わせても右用DLTを使うチャンスは依然として少ない。麻酔科医によっては,右用DLTを使わずに,あるいは苦手なままに一生を終えてしまうかもしれない。
本論文では世界一右用DLTを愛している “right-sided DLT lover” の著者が,今までの経験に基づくhow to useやtips,各社の右用DLTを紹介する。講演では,今まで趣味で集めた右用DLT挿入動画をお示しして魅力をお伝えしコロナ禍明けに欧州胸部麻酔学会(European Association of Cardiothoracic Anaesthesiology and Intensive Care:EACTAIC)のthoracic congress(Valencia, Spain)で,右用DLTのハンズオンインストラクターを務めてきた様子もお伝えしたい。
The attractive form and appearance of the right-sided double lumen tubes(DLTs)should appeal to everyone. Right-sided DLTs have traditionally been used in surgical procedures such as those applied to cut the left main bronchus, but the number of cases in which a right-sided DLT has been used is limited. Successful applications of a right-sided DLT in the second(right lung)surgery for patients with upward displacement of the left main bronchus after a left upper lobectomy have been reported. However, even in these cases, there have been few implementations of a right-sided DLT. Anesthesiologists may spend their entire careers without using a right-sided DLT, and some may not be confident about using one.
As the world’s biggest fan of right-sided DLTs, I describe herein how to use them;I provide tips based on my experience, and I introduce the right-sided DLTs made by various companies. If time permits, I will discuss my time as a hands-on right-sided DLT instructor at international activities and my hopes for the future of these excellent tools.

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