Review Translational lung cancer research. 2025 Apr 30;14(4):1042-1060. doi: 10.21037/tlcr-2025-273 Q24.02024
Multidisciplinary international expert consensus on perioperative airway management
多学科国际专家共识：围术期气道管理 翻译改进
Hengrui Liang 1, Guowei Che 2, Fei Cui 1, Junguo Dong 1, Weiquan Gu 3, Chundong Gu 4, Shun Xu 5, Yufeng Ba 6, Kaican Cai 7, Qingdong Cao 8, Chang Chen 9, Chun Chen 10, Qixun Chen 11, Liyang Cheng 12, Gang Feng 13, Yunjiu Gou 14, Wenwei Guo 1, Jinxi He 15, Junming He 16, Jian Hu 17, Ying Huang 1, Wenxi Wang 1, Wenjie Jiao 18, Shunjun Jiang 1, Jun Liu 1, Lan Lan 19, Wei Li 20, Xiaofei Li 21, Zhongcheng Li 22, Yin Li 23, Zhu Liang 24, Hongxu Liu 25, Yingbin Liu 26 27, Xinyu Mei 28, Xicheng Song 29, Daqiang Sun 30, Hui Tian 31, Ziqiang Tian 32, Jianhua Wang 33, Guangsuo Wang 34, Xin Xu 1, Xudong Xiang 35, Guobing Xu 10, Tao Xue 36, Chao Yang 1, Xiaolong Yan 37, Nuo Yang 38, Feng Yao 39, Dalong Yin 40, Xiaochuan Yin 41, Bentong Yu 42, Wei Zhai 43, Yu Zhang 44 45, Guangjian Zhang 46, Xiaowen Zhang 47, Qiang Zhang 48, Yi Zhang 49, Jun Zhao 50, Haihui Zhong 51, Alessandro Brunelli 52, Till Ploenes 53 54, Luca Bertolaccini 55, John Kit Chung Tam 56 57, Min P Kim 58, Majed Refai 59, Michel Gonzalez 60, Adam R Dyas 61, Nicoletta Pia Ardò 62, Hiran C Fernando 63, Giulio Maurizi 64, Gregor J Kocher 65, Giuseppe Marulli 66 67, Álvaro Fuentes-Martín 68, Gianluca Perroni 69, Kyung Soo Kim 70, Maria Rodriguez 71, Marcus Taylor 72, Xusen Zou 1, Wei Wang 1, Jianxing He 1
作者单位 +展开
作者单位
1 Department of Thoracic Surgery, the First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, China.2 Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, China.3 Department of Thoracic Surgery, The First People's Hospital of Foshan, Foshan, China.4 Department of Thoracic Surgery, the First Affiliated Hospital of Dalian Medical University, Dalian, China.5 Department of Thoracic Surgery, The First Hospital of China Medical University, Shenyang, China.6 Department of Thoracic Surgery, The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, China.7 Department of Thoracic Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China.8 Department of Thoracic Surgery and Lung Transplantation, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China.9 Department of Thoracic Surgery, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, China.10 Department of Thoracic Surgery, Fujian Medical University Union Hospital, Fuzhou, China.11 Department of Thoracic Oncological Surgery, Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of Sciences, Hangzhou, China.12 Department of General Surgery, the General Hospital of Southern Theater Command, People's Liberation Army (PLA), Guangzhou, China.13 Department of Thoracic Surgery, School of Medicine, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China.14 Department of Thoracic Surgery, Gansu Provincial Hospital, Lanzhou, China.15 Department of Thoracic Surgery, General Hospital of Ningxia Medical University, Yinchuan, China.16 Department of Hepatobiliary Surgery, Guangdong Province Traditional Chinese Medical Hospital, Guangzhou, China.17 Department of Thoracic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.18 Department of Thoracic Surgery, Affiliated Hospital of Qingdao University, Qingdao, China.19 Department of Anesthesia, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.20 Department of Thoracic Surgery, Weifang People's Hospital, Weifang, China.21 Department of Thoracic Surgery, Xi'an International Medical Centre Hospital, Northwestern University, Xi'an, China.22 Department of Thoracic and Cardiovascular Surgery, Affiliated Hospital of Qinghai University, Xining, China.23 Section of Esophageal and Mediastinal Oncology, Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.24 Department of Cardiothoracic Surgery, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China.25 Department of Thoracic Surgery, Liaoning Cancer Hospital & Institute, Shenyang, China.26 State Key Laboratory of Systems Medicine for Cancer, Shanghai Cancer Institute, Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.27 Department of Biliary-Pancreatic Surgery, Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.28 Department of Thoracic Surgery, The First Affiliated Hospital of USTC, University of Science and Technology of China, Hefei, China.29 Department of Otorhinolaryngology, Head and Neck Surgery, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, China.30 Department of Thoracic Surgery, Tianjin Chest Hospital, Tianjin University, Tianjin, China.31 Department of Thoracic Surgery, Qilu Hospital of Shandong University, Jinan, China.32 Department of Thoracic Surgery, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China.33 Second Department of General Surgery, Shaanxi Provincial People's Hospital, Xi'an, China.34 Department of Thoracic Surgery, The Second Clinical Medical College of Jinan University, Shenzhen People's Hospital, Shenzhen, China.35 No. 2 Department of Thoracic Surgery, The Third Affiliated Hospital of Kunming Medical University, Kunming, China.36 Department of Cardiothoracic Surgery, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China.37 Department of Thoracic Surgery, Tangdu Hospital, The Air Force Military Medical University, Xi'an, China.38 Department of Thoracic and Cardiovascular Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, China.39 Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.40 Department of Hepatobiliary Surgery, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China.41 Department of Thoracic Surgery, The First Affiliated Hospital of Kunming Medical University, Kunming, China.42 Department of Thoracic Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, China.43 Department of Thoracic Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.44 Department of Otolaryngology, Head and Neck Surgery, Yantai Yuhuangding Hospital, Qingdao University, Yantai, China.45 Shandong Provincial Clinical Research Center for Otorhinolaryngologic Diseases, Yantai, China.46 Department of Thoracic Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.47 Department of Otolaryngology-Head and Neck Surgery, The Key Laboratory of Advanced Interdisciplinary Studies Center, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.48 Department of Thoracic Surgery, Beijing Jishuitan Hospital, Capital Medical University, Beijing, China.49 Department of Thoracic Surgery, Xuanwu Hospital, Capital Medical University, Beijing, China.50 Department of Thoracic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, China.51 Department of Thoracic Surgery, Meizhou People's Hospital, Meizhou, China.52 Department of Thoracic Surgery, St. James's University Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, UK.53 Division of Thoracic Surgery, Department of Visceral, Thoracic and Vascular Surgery, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.54 Department of Thoracic Surgery, Fachkrankenhaus Coswig, Coswig, Germany.55 Department of Thoracic Surgery, IEO, European Institute of Oncology IRCCS, Milan, Italy.56 Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.57 Department of Cardiac, Thoracic, and Vascular Surgery, National University Heart Centre Singapore, Singapore, Singapore.58 Division of Thoracic Surgery, Department of Surgery, Houston Methodist Hospital, Houston, TX, USA.59 Department of Thoracic Surgery, Ospedali Riuniti delle Marche, Ancona, Italy.60 Department of Thoracic Surgery, Lausanne University Hospital (CHUV), Lausanne, Switzerland.61 Department of Surgery, University of Colorado School of Medicine, Aurora, CO, USA.62 Thoracic Surgery Unit, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy.63 Department of Cardiothoracic Surgery, Allegheny General Hospital, Pittsburgh, PA, USA.64 Division of Thoracic Surgery, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy.65 Department of Thoracic Surgery, Hirslanden Clinic Beau Site, Bern, Switzerland.66 Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy.67 Thoracic Surgery Unit-IRCCS Humanitas Research Hospital, Rozzano, Italy.68 Thoracic Surgery Department, University Clinical Hospital of Valladolid, University of Valladolid, Valladolid, Spain.69 Division of Thoracic Surgery, IRCCS Ospedale Sacro Cuore Don Calabria, Negrar di Valpolicella, Italy.70 Department of Thoracic and Cardiovascular Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.71 Thoracic Surgery Department, Clínica Universidad de Navarra, Madrid, Spain.72 Department of Cardiothoracic Surgery, Manchester University Hospital Foundation Trust, Wythenshawe Hospital, Manchester, UK.
DOI: 10.21037/tlcr-2025-273 PMID: 40386733
摘要 中英对照阅读
Background: Perioperative airway management is critical for patient safety and optimal surgical outcomes. Effective airway management reduces postoperative pulmonary complications and accelerates recovery. This expert consensus aims to update the earlier consensus based on the latest research and emphasize aspects that were previously overlooked.
Methods: A comprehensive search up to June 2024 was performed. Earlier consensus documents were reviewed to ensure thorough coverage. A modified Delphi method involved 62 domestic experts from various surgical and anesthetic specialties who discussed and voted on preliminary recommendations in face-to-face meetings, requiring ≥70% agreement. Drafts were then reviewed by 18 international experts via email to incorporate diverse insights.
Results: Through the modified Delphi method, consensus was achieved with ≥70% agreement among the 62 domestic experts, ensuring that the preliminary recommendations were robust and widely supported. Additionally, feedback from the 18 international experts provided diverse insights that further refined and validated the recommendations. Recommendations were established for preoperative airway preparation, anesthesia management, surgical approach, postoperative airway management, and managing coexisting respiratory diseases. These recommendations update the perspectives of earlier consensus documents based on the latest research and emphasize non-intubated surgery, inhalation therapy, and individualized treatment for patients with coexisting pulmonary diseases.
Conclusions: This expert consensus provides a valuable reference for clinical practice. Further technological optimization and clinical research are needed to improve perioperative airway management.
Keywords: Perioperative airway management; anesthesia; coexisting pulmonary disease; inhalation therapy; non-intubated surgery.
Copyright © 2025 AME Publishing Company. All rights reserved.
背景：
围手术期气道管理对于患者安全和最佳手术效果至关重要。有效的气道管理可以减少术后肺部并发症，并加快恢复速度。本专家共识旨在基于最新的研究成果更新早期的共识，强调之前被忽视的部分。
方法：
截至2024年6月进行了全面搜索。回顾了早期的共识文件以确保全面覆盖。采用改良德尔菲法，邀请来自不同外科和麻醉专业的62位国内专家面对面讨论并投票表决初步建议，要求至少70%的一致性。然后通过电子邮件由18位国际专家审阅草稿，以纳入多样化的见解。
结果：
通过改良德尔菲法，62位国内专家达成了一致意见（≥70%同意率），确保初步建议具有强大的基础和广泛的支持。此外，来自18位国际专家的反馈提供了多元化的观点，进一步细化并验证了这些建议。制定出了关于术前气道准备、麻醉管理、手术方法、术后气道管理和合并呼吸系统疾病的处理的推荐意见。这些推荐意见基于最新的研究成果更新了早期共识文件的观点，并强调非插管手术、吸入治疗以及针对合并肺部疾病患者的个性化治疗。
结论：
本专家共识为临床实践提供了宝贵的参考。需要进一步的技术优化和临床研究以改进围手术期气道管理。
关键词：围手术期气道管理；麻醉；合并呼吸系统疾病；吸入治疗；非插管手术。
关键词：围手术期气道管理; 多学科国际共识
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