2018, Number 3
Tracheal tumor resection
Abad HRM, Villarreal ERR, Henao RA
Language: Spanish
References: 9
Page: 1-7
PDF size: 122.75 Kb.
ABSTRACT
Objective: To present the evolution of a patient for removal of a tracheal tumor that occluded 95% of its light.Clinical case: Dyspnea with suprasternal retractions. No tolerance of supine decubitus, presence of cough and expectoration. The patient was administered conventional endotracheal general anesthesia. Intubation with tube number 8. The patient was placed in the left lateral decubitus position. A thoracotomy was performed. With the trachea open, the surgeon intubated the left bronchus with tube number 7. Secretions were aspirated, oxygen saturation decreased. A Levine tube was placed in the right lung for apneic oxygenation, which improved the saturation. In the ventilated lung, positive pressure was applied at the end of the expiration of 3 cm of water with an inspired fraction of oxygen of 1. After closing the posterior wall of the trachea, a nasogastric tube was passed through the tube placed via the orotracheal approach. The surgeon fixed the distal end with a clamp. The initial orotracheal tube was removed and a 5.5 tube was placed to intubate the left bronchus selectively through the mouth and complete the suture of the trachea and both bronchi. After the procedure, the tube was removed and both lungs were ventilated.
Conclusions: The trachea surgery represents a great challenge for the anesthesiologist and the surgeon, a reason why good team working relations are essential.
REFERENCES
Beltrán Alandí R. Cirugía de estenosis traqueal: Lesión y resección. Valencia: Consorcio Hospital General Universitario de Valencia; 2010 [citado 31 ago 2018]. Disponible en: https://chguv.san.gva.es/documents/10184/46533/0903_ProtocoloAnestesiaCirResec cTraqueal.pdf/0a5adef2-bd71-4375-9041-d2fd3e6bafd2