Anaesthesia for tracheal resection and anastomosis

J Anaesthesiol Clin Pharmacol. 2022 Jan-Mar;38(1):48-57. doi: 10.4103/joacp.JOACP_611_20. Epub 2021 Dec 30.

Abstract

Tracheal resection anastomosis is one of the most challenging surgeries. Notable advances in this field have made possible a variety of surgical, anesthetic, and airway management options. There are reports of newer approaches ranging from use of supraglottic airway devices, regional anesthesia, and extracorporeal support. Endotracheal intubation with cross-field ventilation and jet ventilation are the standard techniques for airway management followed. These call for multidisciplinary preoperative planning and close communication during surgery and recovery. This review highlights the anesthetic challenges faced during tracheal resection and anastomosis with specific considerations to preoperative workup, classification of tracheal stenosis, airway management, ventilation strategies, and extubation. The newer advances proposed have been reviewed.

Keywords: Cross-field ventilation; jet ventilation; tracheal resection anastomosis; tracheal stenosis.

Publication types

  • Review