{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T20:37:30Z","timestamp":1793824650439,"version":"4.6.1"},"reference-count":42,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T00:00:00Z","timestamp":1767830400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Health Commission of Sichuan Province Medical"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The widespread adoption of video laryngoscopes (VLs) in double-lumen endotracheal tube (DLT) intubation has not resolved controversies regarding their efficacy in improving first-attempt success rates. This study aimed to evaluate the safety and efficacy of pre-shaping DLTs according to the VL blade curvature for tracheal intubation in patients undergoing thoracoscopic surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A total of 90 patients scheduled for elective thoracoscopic surgery under general anesthesia with left-sided DLT intubation were enrolled. The patients were aged \u226518 years and had an American Society of Anesthesiologists (ASA) physical status I or II. All patients were divided into two groups using a random number table method: a video laryngoscope blade curvature-based pre-shaping group (Group P,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200945) and a traditional empirical shaping group (Group T,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200945). All patients underwent total intravenous anesthesia and were intubated under VL. The primary outcome was the first-attempt intubation success rate. Secondary outcomes included tube malposition rate, time for DLT passage through the glottis, total intubation time, mean arterial pressure (MAP), and heart rate (HR) at baseline (pre-induction), post-induction, during intubation, and 5\u2009min post-intubation. Complications related to intubation within 48\u2009h after surgery, such as pharyngolaryngeal pain, hoarseness, and lip and dental injuries, were also documented.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Compared to Group T, Group P demonstrated a significantly higher first-attempt intubation success rate (91.1% vs. 72.7%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.01), shorter time for tube passage through the glottis (14.2\u2009\u00b1\u20093.1 vs. 29.5\u2009\u00b1\u20094.8\u2009s,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.01), and reduced total intubation time (58.3\u2009\u00b1\u200910.2 vs. 82.6\u2009\u00b1\u200912.4\u2009s,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.01). During intubation, Group P exhibited significantly lower MAP and HR compared to Group T (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.05). Furthermore, the incidence of postoperative pharyngolaryngeal pain (13.3% vs. 31.8%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.01) and lip injuries (6.7% vs. 18.2%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.01) within 48\u2009h was markedly lower in Group P.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Pre-shaping DLTs based on VL blade curvature improves the first-attempt intubation success rate while minimizing intubation-related trauma in thoracoscopic surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical trial registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link>https:\/\/www.chictr.org.cn\/bin\/home<\/jats:ext-link>\n                      , identifier ChiCTR2400080906.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2025.1700773","type":"journal-article","created":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T06:37:42Z","timestamp":1767854262000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Pre-shaping double-lumen endotracheal tubes based on video laryngoscope blade curvature enhances first-attempt intubation success rate in patients undergoing thoracoscopic surgery: a randomized controlled 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laryngoscope for double lumen endobronchial tube intubation in patients with manual in-line stabilization: a randomized controlled trial","volume":"97","author":"Yoo","year":"2018","journal-title":"Medicine (Baltimore)"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"312","DOI":"10.1186\/s12871-022-01850-y","article-title":"Right displacement of trachea to reduce right bronchial misplacement of left double lumen tube: a prospective, double-blind, randomized study","volume":"22","author":"Guan","year":"2022","journal-title":"BMC Anesthesiol"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"E903","DOI":"10.21037\/jtd.2017.08.163","article-title":"Bronchial lumen is the safer route for an airway exchange catheter in double-lumen tube replacement: preventable complication in airway management for thoracic surgery","volume":"9","author":"Wu","year":"2017","journal-title":"J Thorac Dis"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"124","DOI":"10.4103\/aca.aca_140_22","article-title":"Choosing the correct-sized adult double-lumen tube: quest for the holy grail","volume":"26","author":"Shah","year":"2023","journal-title":"Ann Card Anaesth"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"2863","DOI":"10.1007\/s13304-024-01935-y","article-title":"Comparison of postoperative pulmonary complications and intraoperative safety in thoracoscopic surgery under non-intubated versus intubated anesthesia: a randomized, controlled, double-blind non-inferiority trial","volume":"76","author":"Wang","year":"2024","journal-title":"Updat Surg"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"72","DOI":"10.1186\/1471-2253-14-72","article-title":"A modified technique to improve the outcome of intubation with a left-sided double-lumen endobronchial tube","volume":"14","author":"Hsu","year":"2014","journal-title":"BMC Anesthesiol"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"1097","DOI":"10.1007\/s12630-015-0432-x","article-title":"Effect of prophylactic benzydamine hydrochloride on postoperative sore throat and hoarseness after tracheal intubation using a double-lumen endobronchial tube: a randomized controlled trial","volume":"62","author":"Chang","year":"2015","journal-title":"Can J Anaesth"},{"key":"ref40","doi-asserted-by":"publisher","first-page":"266","DOI":"10.4103\/joacp.JOACP_79_20","article-title":"A randomized control led study comparing CMAC video laryngoscope and Macintosh laryngoscope for insertion of double lumen tube in patients undergoing elective thoracotomy","volume":"37","author":"Mathew","year":"2021","journal-title":"J Anaesthesiol Clin Pharmacol"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"3903","DOI":"10.21037\/jtd-22-451","article-title":"A randomized comparison between the VivaSight double-lumen tube and standard double-lumen tube intubation in thoracic surgery patients","volume":"14","author":"Palaczynski","year":"2022","journal-title":"J Thorac Dis"},{"key":"ref42","doi-asserted-by":"publisher","first-page":"305","DOI":"10.1097\/EJA.0000000000001959","article-title":"The effects of video double-lumen tubes on intubation complications in patients undergoing thoracic surgery: a randomised controlled study","volume":"41","author":"Shui","year":"2024","journal-title":"Eur J Anaesthesiol"}],"container-title":["Frontiers in 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