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Year : 2021  |  Volume : 4  |  Issue : 2  |  Page : 135-138

Anaesthetic management for removal of intratracheal precarinal tumour: A unique challenge

Department of Anaesthesia, Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute, Mumbai, Maharashtra, India

Correspondence Address:
Dr. Naresh R Kabra
S/O Ramlal N. Kabra, “Ramkunj”, Near Police Station, Gandhinagar, Ambad - 431 204, Jalna, Maharashtra
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/arwy.arwy_30_21

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We present successful management of a case of intratracheal tumour situated just above the carina in a 46-year-old male without any adverse outcome or the need for cardiopulmonary bypass. The tumour was originating from the right lateral wall of trachea just proximal to the carina and partially obstructing the right main bronchus. A reinforced endotracheal tube was guided over a fibreoptic bronchoscope into the left main bronchus and the patient provided one-lung ventilation till the trachea was opened. During tracheal resection and closure, the first reinforced tube was withdrawn till mid-trachea and a second reinforced tube was placed in the left main bronchus under direct vision by the surgeon and used for ventilation. Towards the end of procedure, the first reinforced tube (which had been withdrawn till mid-trachea before the surgeon passed the second tube) was advanced beyond the tracheal opening and used for ventilation. At the end of the procedure, the patient was extubated on table and was subsequently discharged without any complication. Our case illustrates the paramount importance of extensive planning, preparation of the operation theatre, good communication and coordination between all team members while dealing with these difficult cases.

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