Work

Anesthetic management for resection of a massive tracheal tumor via combined electronic bronchoscopy and rigid endoscopy: A case report

Year: 2025

Type: article

Abstract: RATIONALE: Tracheal tumors are a relatively uncommon pathology, with the majority being malignant, accounting for approximately 75% of all tracheal neoplasms. These tumors can lead to airway narrowing and obstruction, resulting in significant respiratory symptoms such as dyspnea. This case report discusses a patient with a tracheal tumor located at the carina, which caused complete obstruction of the left main bronchus and severe narrowing of the right main bronchus. PATIENT CONCERNS: The patient presented with acute dyspnea due to the significant airway obstruction caused by the tumor. DIAGNOSES: Clinical evaluation, along with imaging studies, confirmed the presence of a tracheal tumor located at the carina, obstructing the left main bronchus and severely narrowing the right main bronchus. INTERVENTIONS: The obstruction was managed through a staged approach. Initial interventions included partial tumor resection via flexible bronchoscopy under conscious sedation using dexmedetomidine and nalbuphine, followed by rigid bronchoscopy under general anesthesia using propofol and remimazolam for complete tumor debulking. OUTCOMES: Following the interventions, the patient experienced a resolution of dyspnea, and the airway was successfully restored, leading to a positive clinical outcome. LESSONS: This case illustrates the importance of a staged anesthetic approach in complex airway management, particularly in the context of airway obstruction due to tracheal tumors. Effective anesthesia management facilitated successful tumor removal, highlighting the critical role of comprehensive patient assessment and tailored interventions in improving respiratory function and outcomes.

Source: Medicine

DOI: 10.1097/md.0000000000046410