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气管上段癌切除重建术的麻醉管理:一例报告

Anesthetic Management of Upper Tracheal Cancer Resection and Reconstruction: A Case Report.

作者信息

Choi So Ron, Eom Deuk Won, Lee Tae Young, Jung Ji Wook, Lee Gang Hyun, Lee Seung Cheol, Park Sang Yoong, Kim Tae Hyung

机构信息

Department of Anesthesiology and Pain Medicine, University of Dong-A College of Medicine, Busan, Republic of Korea.

出版信息

Int Med Case Rep J. 2022 Aug 25;15:443-447. doi: 10.2147/IMCRJ.S376721. eCollection 2022.

Abstract

Tracheal tumor resection and reconstruction is the primary treatment for tracheal tumors. The trachea is the surgical site as well as an important channel to ensure ventilation and maintain oxygenation during surgery. In this report, we describe the successful management of an upper tracheal tumor in a 50-year-old patient. The tumor was situated approximately 2-3 cm below the vocal cords, occluding the tracheal lumen by 80%. Conventional orotracheal intubation was expected to be impossible, and the patient was managed with an I-Gel supraglottic airway for mechanical ventilation with the assistance of venovenous extracorporeal membrane oxygenation (VV ECMO). After securing tracheal intubation via the tracheostomy site, VV ECMO was weaned off, and mechanical ventilation was changed to tracheal intubation. Eventually, tracheal tumor resection and reconstruction were successfully performed under general anesthesia. No specific events occurred during anesthetic management. Careful preoperative planning and good teamwork made the procedure possible without complications.

摘要

气管肿瘤切除与重建是气管肿瘤的主要治疗方法。气管既是手术部位,也是手术期间确保通气和维持氧合的重要通道。在本报告中,我们描述了一名50岁患者上气管肿瘤的成功治疗过程。肿瘤位于声带下方约2 - 3厘米处,使气管腔闭塞80%。预计无法进行传统的经口气管插管,因此在静脉 - 静脉体外膜肺氧合(VV ECMO)辅助下,使用I - Gel声门上气道对患者进行机械通气管理。通过气管造口部位确保气管插管后,停用VV ECMO,并将机械通气改为气管插管。最终,在全身麻醉下成功进行了气管肿瘤切除与重建。麻醉管理过程中未发生特殊事件。精心的术前规划和良好的团队协作使得手术得以顺利进行且无并发症发生。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/db94/9423117/ffc1d7200da9/IMCRJ-15-443-g0001.jpg

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