Management of a case of left tracheal sleeve pneumonectomy under cardiopulmonary bypass: Anesthesia perspectives.
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Date
2014-01
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Abstract
The lung tumors with carinal involvement are frequently managed with tracheal sleeve pneumonectomy and
tracheobronchial anastomosis without use of cardiopulmonary bypass (CPB). Various modes of ventilation
have been described during tracheal resection and anastomosis. Use of CPB during this period allows the
procedure to be conducted in a more controlled way. We performed tracheal sleeve pneumonectomy for
adenoid cystic carcinoma of left lung involving carina. The surgery was performed in two stages. In the first
stage, left pneumonectomy was performed and in the second stage after 48 h, tracheobronchial resection
and anastomosis was performed under CPB. Second stage was delayed to avoid excessive bleeding (due
to heparinization) from the extensive vascular raw area left after pneumonectomy. Meticulous peri‑operative
planning and optimal post‑operative care helped in successful management of a complex case, which is
associated with high morbidity and mortality.
Description
Keywords
Adenoid cystic carcinoma, Cardiopulmonary bypass, Tracheobronchial anastomosis, Tracheal sleeve pneumonectomy
Citation
Jyoti Aman, Maheshwari Arun, Shivnani Ganesh, Kumar Arvind. Management of a case of left tracheal sleeve pneumonectomy under cardiopulmonary bypass: Anesthesia perspectives. Annals of Cardiac Anaesthesia. 2014 Jan; 17(1): 62-66.