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Ruiz MD, Grant J, Hernandez J. Bronchoscopic debulking of a feline tracheobronchial carcinoma and long-term outcome. JFMS Open Rep 2018; 4:2055116918767706. [PMID: 29780608 PMCID: PMC5954347 DOI: 10.1177/2055116918767706] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Case summary This report describes a 10-year-old female spayed Russian Blue cat presented with a 5 month history of respiratory difficulty. Thoracic radiographs were suggestive of a central airway obstruction. Bronchoscopy revealed a broad-base mass in the region of the carina. Bronchoscopic debulking was performed using a urinary catheter. Histopathology confirmed the presence of a tracheobronchial carcinoma. Survival from diagnosis was 16 months (480 days), over which time the cat underwent three endoscopic debulking procedures in combination with doxorubicin chemotherapy. Relevance and novel information To our knowledge, this is the first report of a tracheobronchial carcinoma in a cat treated by endoscopic debulking with a urinary catheter and adjuvant chemotherapy with long-term survival time. A review of interventional bronchoscopy performed in humans and in veterinary medicine is described.
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Affiliation(s)
| | | | - Juan Hernandez
- Veterinary Hospital Frégis, Arcueil, France.,Internal Medicine Unit of Oniris, Nantes-Atlantic College of Veterinary Medicine and Food Sciences, Nantes, France
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Bua AS, Combes A, Maitre P, Bongrand Y. Use of endoscopic-guided electrocautery ablation for treatment of tracheal liposarcoma in a dog. J Am Vet Med Assoc 2018; 252:581-585. [PMID: 29461158 DOI: 10.2460/javma.252.5.581] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
CASE DESCRIPTION A 7-year-old 44-kg (97-lb) neutered male Great Pyrenees was referred for evaluation because of episodic dyspnea with cyanosis of 1 to 2 weeks' duration. Three days prior to evaluation, the clinical signs had worsened, including 1 episode of collapse. CLINICAL FINDINGS Thoracic radiography and CT revealed a well-delineated soft tissue mass, located approximately 1.5 cm cranial to the carina and occupying almost 90% of the tracheal lumen. A CBC and serum biochemical analysis were performed, and all results were within reference limits. TREATMENT AND OUTCOME Tracheoscopy confirmed the presence of a broad-based bilobate mass that was protruding from the right dorsal aspect of the trachea and occupied almost the entire tracheal lumen. The mass was successfully resected by endoscopic-guided electrocautery ablation. Findings of histologic evaluation were consistent with a diagnosis of liposarcoma. Immediately following the ablation procedure, the previously noted clinical signs of respiratory tract disease resolved. On follow-up examination 12 months later, no regrowth of the mass was evident on thoracic helical CT and tracheoscopy. CLINICAL RELEVANCE Endoscopic-guided electrocautery ablation of tracheal liposarcoma was a safe and effective minimally invasive treatment for the dog of this report. The procedure was brief and appeared to be well tolerated, resulting in immediate improvement of clinical signs.
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Abstract
The trachea and bronchus surgery is generally performed due to stenosis, traumatic injury, foreign body and tumors. Preoperative evaluation and anesthesia management are very important issues because of higher mortality and morbidity rates. Patients may be asymptomatic, but airway difficulties, hypoxia, stridor, cough, hemoptysis are common conditions in these patient population. The collaboration between the surgeon and the anesthesiologist is very substantial and necessary. Anesthetic techniques include various applications such as one lung ventilation, fiberoptic intubation, jet ventilation, and apneic oxygenation, general anesthesia with or without neuromuscular blockade. In this review, anesthesia management of the trachea and bronchus surgery is evaluated in the light of new knowledge.
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Affiliation(s)
- Zehra Hatipoglu
- Department of Anesthesiology and Reanimation, Çukurova University Faculty of Medicine, Adana, Turkey
| | - Mediha Turktan
- Department of Anesthesiology and Reanimation, Çukurova University Faculty of Medicine, Adana, Turkey
| | - Alper Avci
- Department of Thoracic Surgery, Çukurova University Faculty of Medicine, Adana, Turkey
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Jet Ventilation during Rigid Bronchoscopy in Adults: A Focused Review. BIOMED RESEARCH INTERNATIONAL 2016; 2016:4234861. [PMID: 27847813 PMCID: PMC5101361 DOI: 10.1155/2016/4234861] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Revised: 09/19/2016] [Accepted: 10/05/2016] [Indexed: 12/02/2022]
Abstract
The indications for rigid bronchoscopy for interventional pulmonology have increased and include stent placements and transbronchial cryobiopsy procedures. The shared airway between anesthesiologist and pulmonologist and the open airway system, requiring specific ventilation techniques such as jet ventilation, need a good understanding of the procedure to reduce potentially harmful complications. Appropriate adjustment of the ventilator settings including pause pressure and peak inspiratory pressure reduces the risk of barotrauma. High frequency jet ventilation allows adequate oxygenation and carbon dioxide removal even in cases of tracheal stenosis up to frequencies of around 150 min−1; however, in an in vivo animal model, high frequency jet ventilation along with normal frequency jet ventilation (superimposed high frequency jet ventilation) has been shown to improve oxygenation by increasing lung volume and carbon dioxide removal by increasing tidal volume across a large spectrum of frequencies without increasing barotrauma. General anesthesia with a continuous, intravenous, short-acting agent is safe and effective during rigid bronchoscopy procedures.
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Kim JJ, Moon SW, Kim YH, Choi SY, Jeong SC. Flexible bronchoscopic excision of a tracheal mass under extracorporeal membrane oxygenation. J Thorac Dis 2015; 7:E54-7. [PMID: 25922751 DOI: 10.3978/j.issn.2072-1439.2015.01.26] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2014] [Accepted: 12/15/2014] [Indexed: 01/25/2023]
Abstract
Tracheal tumor is a rare but life-threatening condition that can cause obstruction of the airway. Management of tracheal tumors is very challenging and includes surgical resection, radiotherapy, and therapeutic bronchoscopy. Herein, we present a very rare case of an 88-year-old female patient with a tracheal mass due to direct invasion of a mediastinal teratoma. We devised a new method for resection of the tracheal mass because management of her airway and the tracheal mass by conventional methods was impossible. We successfully resected the tracheal mass with flexible bronchoscopic electrocautery under extracorporeal membrane oxygenation (ECMO) without any complications. When management of a patient's airway and tracheal mass are impossible by conventional methods, this technique may be very useful.
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Affiliation(s)
- Jae Jun Kim
- 1 Department of Thoracic and Cardiovascular Surgery, Uijeongbu St. Mary's Hospital, College of Medicine, the Catholic University of Korea, Seoul, South Korea ; 2 Department of Thoracic and Cardiovascular Surgery, St. Paul's Hospital, College of Medicine, the Catholic University of Korea, Seoul, South Korea
| | - Seok Whan Moon
- 1 Department of Thoracic and Cardiovascular Surgery, Uijeongbu St. Mary's Hospital, College of Medicine, the Catholic University of Korea, Seoul, South Korea ; 2 Department of Thoracic and Cardiovascular Surgery, St. Paul's Hospital, College of Medicine, the Catholic University of Korea, Seoul, South Korea
| | - Yong Hwan Kim
- 1 Department of Thoracic and Cardiovascular Surgery, Uijeongbu St. Mary's Hospital, College of Medicine, the Catholic University of Korea, Seoul, South Korea ; 2 Department of Thoracic and Cardiovascular Surgery, St. Paul's Hospital, College of Medicine, the Catholic University of Korea, Seoul, South Korea
| | - Si Young Choi
- 1 Department of Thoracic and Cardiovascular Surgery, Uijeongbu St. Mary's Hospital, College of Medicine, the Catholic University of Korea, Seoul, South Korea ; 2 Department of Thoracic and Cardiovascular Surgery, St. Paul's Hospital, College of Medicine, the Catholic University of Korea, Seoul, South Korea
| | - Seong Cheol Jeong
- 1 Department of Thoracic and Cardiovascular Surgery, Uijeongbu St. Mary's Hospital, College of Medicine, the Catholic University of Korea, Seoul, South Korea ; 2 Department of Thoracic and Cardiovascular Surgery, St. Paul's Hospital, College of Medicine, the Catholic University of Korea, Seoul, South Korea
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Farhat AA, Ragab M, Abd-Elzaher AH, Attia GA, Torky MS. Bronchoscopic electrocauterization versus argon plasma coagulation as a palliative management for patients with bronchogenic carcinoma. EGYPTIAN JOURNAL OF CHEST DISEASES AND TUBERCULOSIS 2015. [DOI: 10.1016/j.ejcdt.2014.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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El-Dawlatly A, Alnassar S, Abodonya A, Almutlaq N, Hajjar W. Anesthetic considerations of central airway obstruction. Saudi J Anaesth 2011; 5:326-8. [PMID: 21957418 PMCID: PMC3168356 DOI: 10.4103/1658-354x.84113] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Central airway obstruction (CAO) is a serious presentation of lung cancer and associated chest diseases. It presents a real challenge to the anesthesiologist because usually the patient admitted to the hospital as an emergency case with high grade dyspnea scheduled to undergo rigid bronchoscopy for diagnostic and possible therapeutic interventions. In this case report, we described the anesthetic management of a patient who was admitted to our hospital with CAO.
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Regal MAH, El Ghoneimy YA, Aljehani YM. Respiratory distress in patients with central airway obstruction. Indian J Thorac Cardiovasc Surg 2010. [DOI: 10.1007/s12055-010-0021-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Lyu J, Song JW, Hong SB, Oh YM, Shim TS, Lim CM, Lee SD, Koh Y, Kim WS, Kim DS, Choi CM. Bronchoscopic Cryotherapy in Patients with Central Airway Obstruction. Tuberc Respir Dis (Seoul) 2010. [DOI: 10.4046/trd.2010.68.1.6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Jiwon Lyu
- Division of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jin Woo Song
- Division of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sang-Bum Hong
- Division of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Yeon-Mok Oh
- Division of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Tae Sun Shim
- Division of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Chae-Man Lim
- Division of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sang Do Lee
- Division of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Younsuck Koh
- Division of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Woo Sung Kim
- Division of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Dong Soon Kim
- Division of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Chang Min Choi
- Division of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Abstract
The attributable morbidity from central airway obstruction is significant. Airway stenting provides a therapeutic option to manage these complex lesions. This article focuses on the relevant anesthetic considerations of airway stenting in adult patients.
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Lohser J, Brodsky JB. Bronchial stenting through a ProSeal laryngeal mask airway. J Cardiothorac Vasc Anesth 2005; 20:227-8. [PMID: 16616665 DOI: 10.1053/j.jvca.2005.01.036] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2004] [Indexed: 11/11/2022]
Affiliation(s)
- Jens Lohser
- Department of Anesthesia, Stanford University School of Medicine, Stanford, CA 94305-5640, USA.
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Abstract
Significant advances have been achieved in surgical and anesthetic techniques for the treatment of patients presenting with a variety of complex intrathoracic lesions. Despite the technologic advances, these patients continue to pose a challenge for anesthesiologists to provide safe and effective clinical care. A thorough understanding of the patient's underlying pathology inclusive of a detailed preoperative evaluation and effective communication between the surgical and anesthesia teams would help to ensure a favorable outcome.
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Affiliation(s)
- Erin A Sullivan
- Department of Anesthesiology, University of Pittsburgh Medical Center Presbyterian Hospital, 200 Lothrop Street, PUH C-224, Pittsburgh, PA 15213, USA.
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