{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T06:12:04Z","timestamp":1779343924565,"version":"3.51.4"},"reference-count":34,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T00:00:00Z","timestamp":1779321600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"\n Background<\/jats:title>\n Double-lumen tube (DLT) is generally regarded as the gold standard for one-lung ventilation during thoracic surgery. Compared with DLT, video double-lumen tube (VDLT) has an integrated camera, allowing continuous visualization of its position in the trachea. However, the clinical efficacy of VDLT for one-lung ventilation in thoracic surgery is unclear. This meta-analysis aims to evaluate the clinical efficacy of VDLT for one-lung ventilation in thoracic surgery.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n The PubMed, EMBASE, Web of Science, the Cochrane Library, CNKI, WanFang, and CBM databases were searched for relevant studies from inception to July 2025. This meta-analysis used RevMan and Stata software to implement statistical analysis. The primary outcome was the intubation time. Sensitivity analysis and Egger\u2019s test were performed to evaluate the stability of the results and the publication bias.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Eighteen studies involving 1,332 patients were included. For the primary outcome intubation time, extreme and unexplained between-study heterogeneity was observed (I\n 2<\/jats:sup>\n =\u202f99%). A random-effects model was applied, and the pooled result suggested a trend toward shorter intubation time in the VDLT group (MD\u202f=\u202f\u2212102.68 [95% CI: \u2212123.71 to \u221281.66],\n p<\/jats:italic>\n \u202f&lt;\u202f0.00001). Meta-analysis also revealed that the VDLT group exerted a higher first-attempt success rate (OR\u202f=\u202f8.04, 95% CI [2.17 to 29.74],\n p<\/jats:italic>\n \u202f=\u202f0.002), lower mean arterial pressure (MD\u202f=\u202f\u221216.85 [95% CI: \u221221.67 to \u221212.02],\n p<\/jats:italic>\n \u202f&lt;\u202f0.00001) and heart rate (MD\u202f=\u202f\u221211.32 [95% CI: \u221219.80 to \u22122.85],\n p<\/jats:italic>\n \u202f=\u202f0.009) after intubation, a shorter repositioning time after dislodgement (MD\u202f=\u202f\u221250.91 [95% CI: \u221267.30 to \u221234.52],\n p<\/jats:italic>\n \u202f&lt;\u202f0.00001), and a lower incidence of sore throat (OR\u202f=\u202f0.62, 95% CI [0.39 to 0.98],\n p<\/jats:italic>\n \u202f=\u202f0.04). No significant differences regarding the incidence of dislodgement during positioning and surgery, quality of lung collapse, or the incidence of hoarseness after surgery were noted between the 2 group.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Compared with the DLT, VDLT may provide modest clinical advantages of a shorter intubation time, higher first-attempt success rate, lower mean arterial pressure and heart rate after intubation, shorter repositioning time after dislodgement, and lower incidence of sore throat. However, the primary outcome of intubation time is limited by extreme between-study heterogeneity that could not be explained. Standardized multicenter international randomized trials are warranted to confirm the clinical efficacy of VDLT.<\/jats:p>\n <\/jats:sec>\n \n Systematic review registration<\/jats:title>\n \n https:\/\/www.crd.york.ac.uk\/PROSPERO\/view\/CRD420251138139<\/jats:ext-link>\n , Identifier: CRD420251138139.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fmed.2026.1819031","type":"journal-article","created":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T05:46:15Z","timestamp":1779342375000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical efficacy of video double-lumen tube for one-lung ventilation in thoracic surgery: a meta-analysis of randomized controlled trials"],"prefix":"10.3389","volume":"13","author":[{"given":"Li","family":"Jiang","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, Hebei General Hospital","place":["Shijiazhuang, Hebei, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaoqian","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Hebei General Hospital","place":["Shijiazhuang, Hebei, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yue","family":"Yuan","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Hebei General Hospital","place":["Shijiazhuang, Hebei, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yi","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Hebei General Hospital","place":["Shijiazhuang, Hebei, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ge","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Hebei General Hospital","place":["Shijiazhuang, Hebei, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dong","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Hebei General Hospital","place":["Shijiazhuang, Hebei, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,5,21]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"272","DOI":"10.4103\/sja.sja_78_21","article-title":"Lung separation in adult thoracic anesthesia","volume":"15","author":"Huybrechts","year":"2021","journal-title":"Saudi J Anaesth"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"102402","DOI":"10.1016\/j.eclinm.2023.102402","article-title":"Effect of intubation in lateral position on placement of a double-lumen tube in patients undergoing unilateral video-assisted thoracic surgery: a randomied clinical trial","volume":"67","author":"Zhang","year":"2024","journal-title":"EClinicalMedicine"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"159","DOI":"10.1007\/s41669-019-0163-y","article-title":"A cost-effectiveness analysis comparing the VivaSight double-lumen tube and a conventional double-lumen tube in adult patients undergoing thoracic surgery involving one-lung ventilation","volume":"4","author":"Larsen","year":"2020","journal-title":"Pharmacoecon Open"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"2385","DOI":"10.21037\/jtd-23-309","article-title":"The video double-lumen tube: does it have a future?","volume":"15","author":"Marchant","year":"2023","journal-title":"J Thorac Dis"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"218","DOI":"10.1186\/s13019-024-02663-5","article-title":"Video double-lumen tube for one lung ventilation: implementation and experience in 343 cases of routine clinical use during the first 20 months of the SARS-CoV-2 pandemic","volume":"19","author":"Irouschek","year":"2024","journal-title":"J Cardiothorac Surg"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"1090233","DOI":"10.3389\/fsurg.2023.1090233","article-title":"Hypoxemia in thoracoscopic lung resection surgery using a video double-lumen tube versus a conventional double-lumen tube: a propensity score-matched analysis","volume":"10","author":"Wang","year":"2023","journal-title":"Front Surg"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"1259","DOI":"10.1111\/anae.13177","article-title":"Comparison of VivaSight double-lumen tube with a conventional double-lumen tube in adult patients undergoing video-assisted thoracoscopic surgery","volume":"70","author":"Levy-Faber","year":"2015","journal-title":"Anaesthesia"},{"key":"ref8","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"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"n71","DOI":"10.1016\/j.jclinepi.2021.03.001","article-title":"The PRISMA 2020 statement: an updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"1785","DOI":"10.1177\/0962280216669183","article-title":"Optimally estimating the sample mean from the sample size, median, mid-range, and\/or mid-quartile range","volume":"27","author":"Luo","year":"2018","journal-title":"Stat Methods Med Res"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"14898","DOI":"10.1136\/bmj.l4898","article-title":"RoB 2: a revised tool for assessing risk of bias in randomised trials","volume":"366","author":"Hr\u00f3bjartsson","year":"2019","journal-title":"BMJ"},{"key":"ref12","first-page":"1689","article-title":"Efficacy of visual dual lumen bronchial catheter versus conventional dual lumen bronchial catheter in thoracic surgery","volume":"31","author":"Chen","year":"2024","journal-title":"Chin J Prim Med Pharm"},{"key":"ref13","first-page":"733","article-title":"Comparison of positioning between video double-lumen tube and common fibrous bronchus","volume":"40","author":"Fei","year":"2019","journal-title":"J Hebei Med Univ"},{"key":"ref14","first-page":"618","article-title":"Application of visual double lumen endotracheal tube in emergency operation of severe chest trauma","volume":"22","author":"Fu","year":"2021","journal-title":"J Clin Emerg"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"267","DOI":"10.1053\/j.jvca.2017.05.016","article-title":"A randomized controlled study of the use of video double-lumen endobronchial tubes versus double-lumen endobronchial tubes in thoracic surgery","volume":"32","author":"Heir","year":"2018","journal-title":"J Cardiothorac Vasc Anesth"},{"key":"ref16","first-page":"42","article-title":"Application of VivaSight double lumen tube of lung isolation in anesthesia residents","volume":"36","author":"Huang","year":"2020","journal-title":"J Clin Anesthesiol"},{"key":"ref17","first-page":"807","article-title":"Effect of video double-lumen tube on airway management during thoracoscopic surgery","volume":"39","author":"Jing","year":"2018","journal-title":"Anhui Med J"},{"key":"ref18","first-page":"42","article-title":"Comparison of the intubating of doublelumen endobronchial tube assisted with fiberobronchoscope and the intubating of double-lumen endobronchial tube with an integrated camera(VivaSight-DLTM)","volume":"24","author":"Li","year":"2018","journal-title":"China J Endosc"},{"key":"ref19","first-page":"1564","article-title":"Application advantage of video double-lumen tube in double-lumen endobronchial tubes","volume":"18","author":"Li","year":"2018","journal-title":"Chin Remedies Clin"},{"key":"ref20","first-page":"286","article-title":"Right visual double lumen endotracheal tube versus common right double lumen endotracheal tube lung isolation technique:a randomized controlled study","volume":"30","author":"Liu","year":"2023","journal-title":"Chin J Clin Thorac Cardiovasc Surg"},{"key":"ref21","first-page":"28","article-title":"Application value of visual double-lumen bronchial catheter in pulmonary isolation","volume":"25","author":"Lv","year":"2018","journal-title":"Chin Mod Med"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"6533","DOI":"10.21037\/jtd-20-1595","article-title":"Comparing the rate of fiberoptic bronchoscopy use with a video double lumen tube versus a conventional double lumen tube-a randomized controlled trial","volume":"12","author":"Onifade","year":"2020","journal-title":"J Thorac Dis"},{"key":"ref23","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":"ref24","doi-asserted-by":"publisher","first-page":"762","DOI":"10.1007\/s12630-015-0329-8","article-title":"Intubation with VivaSight or conventional left-sided double-lumen tubes: a randomized trial","volume":"62","author":"Schuepbach","year":"2015","journal-title":"Can J Anaesth"},{"key":"ref25","first-page":"37","article-title":"Observation on effect of visual double-lumen bronchial catheter in one-lung ventilation of obese patients","volume":"25","author":"Shi","year":"2021","journal-title":"J Clin Med Pract"},{"key":"ref26","first-page":"471","article-title":"Safety and effect assessment of intubation with visual double-lumen bronchial tube: a randomized trial","volume":"46","author":"Zhao","year":"2017","journal-title":"Acta Med Univ Sci Technol Huazhong"},{"key":"ref27","first-page":"72","article-title":"Clinical application of the visual double-lumen bronchial tube in thoracic operation","volume":"24","author":"Zhou","year":"2018","journal-title":"Chin J Endosc"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"3000605251315023","DOI":"10.1177\/03000605251315023","article-title":"Interaction between intubation and stress regarding hemodynamic and hormonal changes","volume":"53","author":"Abd Elhafez","year":"2025","journal-title":"J Int Med Res"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"CD009798","DOI":"10.1002\/14651858.CD009798.pub2","article-title":"Dexmedetomidine for the management of awake fibreoptic intubation","volume":"2014","author":"He","year":"2014","journal-title":"Cochrane Database Syst Rev"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"302","DOI":"10.1213\/ANE.0000000000000808","article-title":"Lung injury after one-lung ventilation: a review of the pathophysiologic mechanisms affecting the ventilated and the collapsed lung","volume":"121","author":"Lohser","year":"2015","journal-title":"Anesth Analg"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"76","DOI":"10.1016\/j.janh.2017.05.002","article-title":"The history of one-lung anesthesia and the double-lumen tube","volume":"3","author":"McGrath","year":"2017","journal-title":"J Anesth Hist"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"e123910","DOI":"10.5812\/aapm-123910","article-title":"The effect of softening of endotracheal tubes on the decrement of postoperative hoarseness and sore throat","volume":"12","author":"Mohseni","year":"2022","journal-title":"Anesth Pain Med"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"2356","DOI":"10.1097\/MS9.0000000000000786","article-title":"Incidence and risk factors for postoperative sore throat after general anesthesia with endotracheal intubation: prospective cohort study","volume":"85","author":"Bekele","year":"2023","journal-title":"Ann Med Surg"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"1544","DOI":"10.1053\/j.jvca.2015.04.031","article-title":"Evaluation of the double-lumen tube Vivasight-DL (DLT-ETView): a prospective single-center study","volume":"29","author":"Massot","year":"2015","journal-title":"J Cardiothorac Vasc Anesth"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1819031\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T05:46:19Z","timestamp":1779342379000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1819031\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,21]]},"references-count":34,"alternative-id":["10.3389\/fmed.2026.1819031"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2026.1819031","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,21]]},"article-number":"1819031"}}