Marwaha Ashwin, Kumar Akhil, Sharma Shikha, Sood Jayashree
Institute of Anaesthesiology, Pain and Perioperative Medincine, Sir Ganga Ram Hospital, New Delhi, India.
J Anaesthesiol Clin Pharmacol. 2022 Jan-Mar;38(1):48-57. doi: 10.4103/joacp.JOACP_611_20. Epub 2021 Dec 30.
Tracheal resection anastomosis is one of the most challenging surgeries. Notable advances in this field have made possible a variety of surgical, anesthetic, and airway management options. There are reports of newer approaches ranging from use of supraglottic airway devices, regional anesthesia, and extracorporeal support. Endotracheal intubation with cross-field ventilation and jet ventilation are the standard techniques for airway management followed. These call for multidisciplinary preoperative planning and close communication during surgery and recovery. This review highlights the anesthetic challenges faced during tracheal resection and anastomosis with specific considerations to preoperative workup, classification of tracheal stenosis, airway management, ventilation strategies, and extubation. The newer advances proposed have been reviewed.
气管切除吻合术是最具挑战性的手术之一。该领域的显著进展使得多种手术、麻醉和气道管理选择成为可能。有报道称出现了从使用声门上气道装置、区域麻醉到体外支持等更新的方法。采用跨野通气和喷射通气的气管内插管是随后气道管理的标准技术。这些都需要多学科的术前规划以及手术和恢复期间的密切沟通。本综述重点介绍了气管切除和吻合术中面临的麻醉挑战，并特别考虑了术前检查、气管狭窄的分类、气道管理、通气策略和拔管。对提出的更新进展进行了综述。
