Modified and newly designed right-sided double-lumen endobronchial tubes are complementary.

To the Editor:—We read with great interest the case report on the application of a newly designed right-sided, double-lumen endobronchial tube (R-DLT) in patients with a very short right mainstem bronchus. However, in citing our work on the improvement of the endobronchial positioning of the R-DLT, Hagihira et al. stated that we modified the design of the bronchial cuff and that these changes seem to offer little improvement. This statement is inconsistent with our published manuscript which demonstrates, on a randomized series of 80 patients, that the modified enlarged area of the lateral orifice (and not the bronchial cuff as stated by Hagihira et al.) improve the success rate of final positioning from 74 to 97% with a P 0.0109. These two new versions of the R-DLT are not intended to solve the same problem, but the final objective, improvement of the use of R-DLT, is similar. We thank Dr. Hagihira for this interesting case report. While this new R-DLT may become a useful tool for thoracic anesthesiologists, we would first encourage them to validate its use with a randomized study.