Dammalapati Pavan Kumar
Consultant Cardiac Anaesthesiologist, Aster Ramesh Hospitals, Near ITI college Bus stop, Vijayawada, Andhra Pradesh 520008, India.
Indian J Thorac Cardiovasc Surg. 2025 Jan;41(1):45-52. doi: 10.1007/s12055-024-01798-3. Epub 2024 Aug 21.
Mediastinal tumors are common neoplasms among the pediatric population. The symptoms may be due to the direct compression effects on the surrounding structures or "B" like symptoms of specific lymphomas or due to paraneoplastic syndrome. The cardiovascular and respiratory consequences of the compression effects along with the unique physiological nature of the pediatric airway place the anesthesiologist in a difficult situation and face a new situation called "can intubate-cannot ventilate." This clinical scenario is not rare, with physicians commonly being confronted with similar situations in patients with severe bronchospasm. This entity has not been incorporated in any of the difficult airway algorithms. But the mediastinal tumors differ from bronchospasm because they cause physical external compression of the airway. This review will bring the readers the common anterior mediastinal tumors in pediatrics, the physiological differences in the pediatric airway in relation to the compression effects of the mediastinal tumors, and the management aspects of the different surgical aspects of the tumor.
纵隔肿瘤是儿科人群中常见的肿瘤。症状可能是由于对周围结构的直接压迫作用，或特定淋巴瘤的“B”类症状，或由于副肿瘤综合征。压迫作用对心血管和呼吸的影响，以及小儿气道独特的生理特性，使麻醉医生处于困难境地，并面临一种称为“能插管-不能通气”的新情况。这种临床情况并不罕见，医生在患有严重支气管痉挛的患者中常遇到类似情况。这一情况尚未被纳入任何困难气道处理流程中。但纵隔肿瘤与支气管痉挛不同，因为它们会导致气道受到外部物理压迫。本文综述将向读者介绍儿科常见的前纵隔肿瘤、小儿气道与纵隔肿瘤压迫作用相关的生理差异，以及肿瘤不同手术方面的处理要点。
