Extracorporeal membrane oxygenation for the anesthetic management of a patient with severe airway stenosis caused by thyroid carcinoma invasion

Ikeda, Yoshifumi; Saito, Yoshiyuki; Kadomura, Tomohisa; Yamada, Roppei; Shibuya, Shiroshi; Itoh, Hideki; Ishiwa, Dai; Tsuji, Kiyomi; Nagashima, Zenko; Segawa, Satoru

doi:10.1007/s00595-021-02331-4

Cited by 5 publications

(5 citation statements)

References 20 publications

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“…However, in our case, awake cricothyroidotomy/tracheostomy was challenging due to the diffuse mass (about 7.091 cm from the trachea to the skin), bleeding tendency, and distorted anatomy. In another report, ECMO was recommended in a case of severe airway stenosis (4.9 mm at the narrowest portion) (5). However, in our case, it was also difficult to perform ECMO due to the expensive cost and its questionable feasibility in patients with malignant tumors.…”

Section: Discussionmentioning

confidence: 70%

“…Therefore, we still need to refine and update the guidelines for the management of DAs. To date, various challenging cases have been reported and solved by anesthesiologists and otolaryngologists, although differences exist in the techniques and strategies used for the management of DAs (2)(3)(4)(5). However, the descriptions of the specific DA types, which have not been successfully resolved by anesthesiologists and otolaryngologists except through ECMO, have not been incorporated into standard protocols.…”

Section: Introductionmentioning

confidence: 99%

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The “impossibly difficult airway” for anesthesiologists and otolaryngologists: a case description

Zhang¹,

Feng²,

Sun³

et al. 2023

Quant Imaging Med Surg

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Section: Discussionmentioning

confidence: 70%

Section: Introductionmentioning

confidence: 99%

The “impossibly difficult airway” for anesthesiologists and otolaryngologists: a case description

Zhang¹,

Feng²,

Sun³

et al. 2023

Quant Imaging Med Surg

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“…In order to reduce the risk and simplify the surgical procedure, some previous studies reported the use of ECMO and performed TRR without obstruction of tracheal intubation. [6][7][8] We considered several anesthetic techniques that have been used in patients requiring TRR. 3,9,10 Our main purpose was to emphasize the issues that we faced at every step of treatment.…”

Section: Discussionmentioning

confidence: 99%

Anesthetic Management of Upper Tracheal Cancer Resection and Reconstruction: A Case Report

Choi¹,

Eom²,

Lee³

et al. 2022

IMCRJ

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Tracheal tumor resection and reconstruction is the primary treatment for tracheal tumors. The trachea is the surgical site as well as an important channel to ensure ventilation and maintain oxygenation during surgery. In this report, we describe the successful management of an upper tracheal tumor in a 50-year-old patient. The tumor was situated approximately 2-3 cm below the vocal cords, occluding the tracheal lumen by 80%. Conventional orotracheal intubation was expected to be impossible, and the patient was managed with an I-Gel supraglottic airway for mechanical ventilation with the assistance of venovenous extracorporeal membrane oxygenation (VV ECMO). After securing tracheal intubation via the tracheostomy site, VV ECMO was weaned off, and mechanical ventilation was changed to tracheal intubation. Eventually, tracheal tumor resection and reconstruction were successfully performed under general anesthesia. No specific events occurred during anesthetic management. Careful preoperative planning and good teamwork made the procedure possible without complications.

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“…In seven cases of reported intraoperative ECLS use (4.2%), the trachea was severely obstructed by a tumor originating from surrounding structures. These malignancies were limited to thyroid cancer (n=4) ( 19 , 40 , 41 ); and lymphoma (n=3) ( 8 , 18 , 22 ), and the surgeries performed consisted mainly in resecting the tumor and a segmental portion of the trachea (n=6). A surgical debulking was performed in one case ( 8 ).…”

Section: Indications For Surgery With Intraoperative Extracorporeal S...mentioning

confidence: 99%

Current use of extracorporeal life support in airway surgery: a narrative review

Slama¹,

Störk²,

Collaud³

et al. 2023

J Thorac Dis

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Background and Objective: Extracorporeal life support (ECLS) is widely used in patients with severe respiratory or cardiocirculatory failure. The most commonly used extracorporeal membrane oxygenation (ECMO) modes are veno-venous (V-V) and veno-arterial (V-A) ECMO, which can both be achieved by various types of vascular cannulation. Within the scope of tracheobronchial surgery, intraoperative ECLS may occasionally be necessary to provide sufficient oxygenation to a patient throughout a procedure, especially when conventional ventilation strategies are limited. Additionally, V-A ECMO can provide cardiopulmonary support in emergencies and in cases where hemodynamic instability can occur.Methods: This narrative literature review was carried out to identify the use and the specifics of ECLS in airway surgery over the last years. Data from 168 cases were summarized according to the indication for surgery and the mode of ECLS (V-V, V-A).

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Extracorporeal membrane oxygenation for the anesthetic management of a patient with severe airway stenosis caused by thyroid carcinoma invasion

Cited by 5 publications

References 20 publications

The “impossibly difficult airway” for anesthesiologists and otolaryngologists: a case description

The “impossibly difficult airway” for anesthesiologists and otolaryngologists: a case description

Anesthetic Management of Upper Tracheal Cancer Resection and Reconstruction: A Case Report

Current use of extracorporeal life support in airway surgery: a narrative review

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