Analysis of anesthetic methods for tracheal resection and reconstruction with artificial trachea:a report of 25 cases
10.3321/j.issn:0529-5815.2008.13.006
- VernacularTitle:气管切除与人工气管重建手术25例麻醉方法分析
- Author:
Wei ZHAO
1
;
Cheng-Hui LI
;
Nai-Guang JIA
;
Hong-Liang FEL
;
Feng-Rui ZHAO
Author Information
1. 卫生部中日友好医院
- Keywords:
Anesthesia;
Thoracic surgical procedures;
Trachea
- From:
Chinese Journal of Surgery
2008;46(13):980-984
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze and discuss the anesthetic methods and processes for the operations including long-segment resection of the trachea and one-stage anastomosis or reconstruction with artificial trachea.Methods The clinical data of 25 cases from January 1987 to August 2007 with trachea diseases were analyzed retrospectively.There were 10 cases with benign diseases and 15 cases with malignant diseases.All cases represented tracheal stenosis.Some cases represented severe dyspnea.The length of the tracheal lesions was from 2.5 to 7.5 cm.The longest resection of the trachea was 8.0 cm.Direct reanastomosis were carried out in 14 cases.Reconstruction with artificial trachea were carried out in 7 cases.Thirteen cases underwent general anesthesia with endotracheal intubation only,while 2 cases were assisted with artificial cardiopulmonary bypass.Eight cases were intubated via existed tracheotomy.Two cases received bedside tracheotomy with local anesthesia.Two cases were assisted with high frequency jet ventilation.During the operation,a tube was inserted into the distal trachea or contralateral main bronchus to maintain anesthesia and ventilation after the trachea resection.Results All of the 25 patients had good outcome.There was no death caused by anesthesia or operation.However,transient lower SaO2 was found in 2 cases because of the difficult intubation of left main bronchus after the resection of the trachea.One case was ventilated with only lower lobe because of the extra-deep intubation of the left main bronchus.Anastomosis dehiscence happened in 1 case when the non-balloon trachea tube was used immediately after the operation.Conclusions The mortality of anesthesia for tracheal operation are quite high.Therefore,individual treatment with carefully-designed anesthetic and operative protocol,and good communications and cooperation between anesthesiologists and surgeons is the key factor for the success of anesthesia and operation.
