Management of complications of tracheal surgery—a case of dehiscence

Abstract

We report a case of tracheal stenosis in a patient with immune thrombocytopenia who presented 4 yr after splenectomy. The 20-yr progression of the stenosis and management, including resection, is charted. The period after resection was complicated by wound infection, surgical emphysema, mediastinitis and dehiscence of the anastomosis of the trachea. The management of patients with tracheal lesions is discussed, but concentrates on airway care after tracheal resection when complications developed. A laryngeal mask airway was used to stabilize an uncuffed tracheal tube at the site of dehiscence.

Prolonged Use of the Laryngeal Mask Airway ProSealTM: A Report of Seven Cases Lasting 5-11 h

“…A meta-analysis into prolonged use of the LMA Classic TM (based on 16 anecdotal reports, 4 descriptive [20,21] and 7 comparative studies) concluded that there was reasonable evidence supporting its use for 2-4 h, some evidence for 4-8 h, but little evidence for more than 8 h [22]. Interestingly, the longest duration the LMA Classic TM has been in situ is 4 days in neonates [23] and 11 days in adults [24] and there were no untoward effects.…”

Endobronchial tubes – a case for re‐evaluation

“…For a modern generation of users, the availability of fibreoptic bronchoscopic and tube exchange catheter converts this disadvantage into an advantage: the endobronchial tube can easily be repositioned and/or serve as an excellent conduit for other devices, including ‘railroad’ bougies for situations when access with a double lumen tubes is difficult. It was these that made it the choice for securing the airway in this case as it anticipated the improvisation that often is a necessary part of the conduct of tracheal resection [17, 18].…”