H-K Jeon1, Y K So, J-H Yang, H-S Jeong. 1. Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Abstract
OBJECTIVE: Local extension of thyroid carcinoma can result in massive invasion of the trachea, causing severe airway compromise. The pre- and peri-operative management of such airway compromise is difficult but critical. We report the use of extracorporeal oxygenation support as an alternative peri-operative airway management option in such a situation. This approach facilitated curative surgery in a patient with papillary thyroid carcinoma invading the trachea. METHOD: We present a case report regarding extracorporeal oxygenation support in a patient with locally advanced thyroid carcinoma. RESULTS: The patient was a 68-year-old woman with aggressive thyroid papillary carcinoma invading the trachea. The airway was almost totally obstructed, and tracheal resection and end-to-end anastomosis was planned. A venovenous bypass catheter was placed for cardiopulmonary bypass, using the bilateral femoral veins. Curative surgery and reconstruction were then performed successfully, under general anaesthesia assisted by cardiopulmonary bypass oxygenation. CONCLUSION: Cardiopulmonary bypass oxygenation is a safe and effective alternative airway management option in patients with locally aggressive thyroid cancer.
OBJECTIVE: Local extension of thyroid carcinoma can result in massive invasion of the trachea, causing severe airway compromise. The pre- and peri-operative management of such airway compromise is difficult but critical. We report the use of extracorporeal oxygenation support as an alternative peri-operative airway management option in such a situation. This approach facilitated curative surgery in a patient with papillary thyroid carcinoma invading the trachea. METHOD: We present a case report regarding extracorporeal oxygenation support in a patient with locally advanced thyroid carcinoma. RESULTS: The patient was a 68-year-old woman with aggressive thyroid papillary carcinoma invading the trachea. The airway was almost totally obstructed, and tracheal resection and end-to-end anastomosis was planned. A venovenous bypass catheter was placed for cardiopulmonary bypass, using the bilateral femoral veins. Curative surgery and reconstruction were then performed successfully, under general anaesthesia assisted by cardiopulmonary bypass oxygenation. CONCLUSION: Cardiopulmonary bypass oxygenation is a safe and effective alternative airway management option in patients with locally aggressive thyroid cancer.
Authors: J Adam Law; Natasha Broemling; Richard M Cooper; Pierre Drolet; Laura V Duggan; Donald E Griesdale; Orlando R Hung; Philip M Jones; George Kovacs; Simon Massey; Ian R Morris; Timothy Mullen; Michael F Murphy; Roanne Preston; Viren N Naik; Jeanette Scott; Shean Stacey; Timothy P Turkstra; David T Wong Journal: Can J Anaesth Date: 2013-10-17 Impact factor: 5.063