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Revista Cubana de Anestesiología y Reanimación

ISSN 1726-6718 (Electronic)
Revista Cubana de Anestesiología y Reanimación
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2018, Number 3

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Revista Cubana de Anestesiología y Reanimación 2018; 17 (3)

Tracheal tumor resection

Abad HRM, Villarreal ERR, Henao RA
Full text How to cite this article

Language: Spanish
References: 9
Page: 1-7
PDF size: 122.75 Kb.


Key words:

tracheal stenosis, terminal resection, anesthetic management.

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

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  2. Tamariz-Cruz O, Castro-Garcés L. Manejo de la vía aérea en tráquea con tumor intralaminal. Consideraciones relacionadas con traqueoplastía. Rev Mexicana Anest. 2011 [citado sep 2018];34(4). Disponible en: http://www.medigraphic.com/rma

  3. Mendoza López RW, Nieto Rodríguez MA, Motta Amézquita LG. Manejo anestésico en cirugía de traqueoplastia en un paciente con estenosis traqueal por intubación prolongada. Rev Sanid Milit Mex. 2017;71(6):5509-564.

  4. Chacón R, González L, Montalbán C. Manejo de la vía aérea en procedimientos de la vía aérea superior. Rev Chil Anest. 2010;39:141-51.

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  6. Grillo HC. Anesthetic management of tracheal resection and reconstruction. Anesthe & Analg. 1969;48:884-90.

  7. Grillo HC, Donahue DM. Posintubation tracheal stenosis. Chest Surg Clin N Am. 1996;6(7):725-31.

  8. 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

  9. Edward Morgan JR, Mikhail SM, Murray MJ. Anestesiología Clínica. 4ta Edición. España: Editorial El Manual Moderno; 2009. p 541.




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Revista Cubana de Anestesiología y Reanimación. 2018;17