Maurya P, Gupta N, Dhamija E, Kumar V
All India Institute of Medical Sciences New Delhi India.
Anaesth Rep. 2024 Oct 3;12(2):e12328. doi: 10.1002/anr3.12328. eCollection 2024 Jul-Dec.
In patients who have undergone laryngectomy followed by permanent tracheostomy, managing the airway for one-lung ventilation during lung surgery may present a challenge for anaesthetists. This case report discusses a 45-year-old man with a permanent tracheostomy after a laryngectomy performed for laryngeal carcinoma 5 years ago. He was scheduled to undergo excision of a right bronchial mass for which one-lung ventilation was required. An adjustable Flange Hyperflex™ Tracheostomy tube (Bivona® Silicone Tracheostomy tube, Smiths Medical ASD, Inc., Gary, Indiana, USA) was used for this purpose and the tube was guided into the left main bronchus with a bronchoscope. Appropriate lung isolation was achieved using this technique, and there were no airway-related complications during or after the surgery. This case report shows that a Hyperflex™ tracheostomy tube can be successfully utilised in challenging airway scenarios in patients with a tracheostomy, where other options may not be feasible.
对于接受喉切除术后行永久性气管造口术的患者,在肺部手术期间管理单肺通气的气道可能对麻醉师构成挑战。本病例报告讨论了一名45岁男性,他在5年前因喉癌接受喉切除术后行永久性气管造口术。他计划接受右支气管肿物切除术,该手术需要单肺通气。为此使用了可调节的凸缘Hyperflex™气管造口管(Bivona®硅胶气管造口管,美国印第安纳州加里市史密斯医疗ASD公司),并通过支气管镜将该导管导入左主支气管。使用该技术实现了适当的肺隔离,手术期间及术后均未出现气道相关并发症。本病例报告表明,在气管造口术患者面临具有挑战性的气道情况且其他选择可能不可行时,可以成功使用Hyperflex™气管造口管。