Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2022 Jan-Mar;38(1):48-57.
doi: 10.4103/joacp.JOACP_611_20. Epub 2021 Dec 30.

Anaesthesia for tracheal resection and anastomosis

Ashwin Marwaha  1 , Akhil Kumar  1 , Shikha Sharma  1 , Jayashree Sood  1
Affiliations
Review

Anaesthesia for tracheal resection and anastomosis

Ashwin Marwaha et al. J Anaesthesiol Clin Pharmacol. 2022 Jan-Mar.

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.

PubMed Disclaimer

Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
High resolution of CT of neck and thorax with three-dimensional reconstruction
Figure 2
Figure 2
Guardian suture and Guardian roll
Figure 3
Figure 3
Flow diagram of airway control strategy
Figure 4
Figure 4
Cross field ventilation
Figure 5
Figure 5
Ventilation-apnoea-ventilation technique
Figure 6
Figure 6
Tracheal anastamosis
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Smeltz AM, Bhatia M, Arora H, Long J, Kumar PA. Anesthesia for resection and reconstruction of the trachea and carina. J Cardiothorac Vasc Anesth. 2020;34:1902–13. - PubMed
    1. Wright CD, Grillo HC, Wain JC, Wong DR, Donahue DM, et al. Anastomotic complications after tracheal resection:Prognostic factors and management. J Thorac Cardiovasc Surg. 2004;128:731–9. - PubMed
    1. Grillo HC, Mathisen DJ. Diseases of trachea and bronchi. In: Paprella MM, Shumrick DA, Gluckman JL, Meyerhoff WL, editors. Otolaryngology, Head and Neck. 3rd ed. III. Philadelphia: WB Saunders Company; 1991. pp. 2385–97.
    1. Grillo HC. Benign and malignant diseases of the trachea. In: Shields TW, editor. General Thoracic Surgery. 3rd ed. Philadelphia: Lea and Febiger; 1989. pp. 667–79.
    1. Grillo HC, Donahue DM. Post intubation tracheal stenosis. Semin Thorac Cardiovasc Surg. 1996;8:370–80. - PubMed