Double-Lumen Needle Follicular Flushing System versus Single-Lumen Aspiration Needle in IVF/ICSI Patients with Poor Ovarian Response: A Meta-Analysis

Background: The present study performed a meta-analysis to comprehensively analyze existing randomized controlled trials (RCT) involving the use of double-lumen needle in patients with poor ovarian response to explore whether double-lumen needle was good for specific patients. Methods: The PubMed, EMBASE, Cochrane Library databases and two randomized controlled trials registration centers were thoroughly searched until April 2017. The clinical outcomes of IVF/ICSI cycles were compared between two groups with double-lumen needle and single-lumen needle. Results: Four RCT studies were included in this present meta-analysis. The oocytes yield was similar in two groups (OR 0.88, 95%CI 0.66 - 1.16;I2 = 4%). The procedure time with double-lumen needle was significantly longer than that with single-lumen needle (IV = 1.98, 95%CI 0.95 - 3.00;I2 = 86%). The fertilization rate with double-lumen needle was lower than that with single-lumen needle (OR 0.66, 95%CI 0.44 - 0.97;I2 = 0%). There was no significant difference of live birth rate in two groups (OR 0.76, 95%CI 0.32 - 1.76;I2 = 41%). Conclusion: Double-lumen needle could not benefit patients with a POR in terms of the number of oocytes retrieved, oocyte recovery rate, normal fertilization rate, clinical pregnancy rate, and live birth rate, compared with single-lumen needle.

Application of single-lumen tube in rapid recovery of minimally invasive cardiac surgery

Background To explore the effect of single-lumen tube with high-frequency low-tide ventilation mode to optimize nursing measures on patients’rapid recovery.Methods From October 2021 to December 2022,the clinical data of 115 patients who underwent thoracoscopic mitral or/and tricuspid valve surgery in the Department of Cardiology,Guangdong Provincial People’s Hospital were selected.Patients underwent minimally invasive cardiac surgery with single-lumen tube(SLT)or double-lumen tube(DLT),and both groups adopted nursing measures of relieving anxiety and fear before operation,cooperating with doctors accurately and tacitly during operation,and paying attention to airway management after operation.The surgical variables and postoperative complications were recorded and analyzed.Results Among the 115 patients,57 cases were intubated with single-lumen and 58 cases were intubated with double-lumen.In the single-lumen tube group,the 24-hour thoracic fluid volume,postoperative hospitalization time,sputum aspiration times and intensive care unit(ICU)hospitalization time were significantly reduced(P<0.05).But there was no difference in postoperative complications and mechanical ventilation time between the two groups.Conclusion In minimally invasive cardiac surgery,optimizing perioperative nursing measures and inserting single-lumen tracheal intubation can accelerate the postoperative rehabilitation of patients compared with double-lumen tracheal intubation.

A Giant Granuloma of the Vocal Process after Double-Lumen Bronchial Catheter Insertion: A Rare Case Report and Literature Review

Background: Double-lumen endotracheal (DLT) is commonly used for one-lung ventilation and lung separation during thoracic surgery. There are case reports of medically induced laryngeal granulomas, mainly in patients after single-lumen endotracheal (SLT) tube intubation and tracheotomy, and giant granulomas of the vocal cords due to double-lumen bronchial tube insertion have rarely been reported. Case presentation: A 49-year-old female patient underwent single-port thoracoscopy after DLT intubation as well as a wedge resection of the lower lobe of the left lung, which caused giant vocal process granulomas (VPGs) postoperatively. Based on a retrospective analysis of the general condition, current medical history, past medical history, and visual laryngoscopic observation of the vocal folds tissue, which ruled out preoperative vocal fold granuloma formation, we hypothesized that double-lumen bronchial catheter intubation may have been the primary cause of her vocal fold granuloma formation. Conclusions: Giant granuloma of the vocal folds after DLT insertion is a rare postoperative complication;therefore, if DLT intubation is to be performed, the anesthesiologist should choose an appropriate intubation plan and deal with it promptly to avoid the risk factors to ensure that the patient’s perioperative period is safe and smooth. In addition, if postoperative complications are encountered, they should be followed up and observed on time.