title: Lateral position prevents respiratory occlusion during surgical procedure under general anesthesia in the patient of huge anterior mediastinal lymphoblastic lymphoma.
abstract: Lymphoblastic lymphoma, an aggressive mediastinal mass, is recognized as serious threat to the patient in developing cardiac tamponade or airway obstruction. Surgical procedure is often required to relieve clinical emergency and to establish prompt pathological diagnosis. However, in such a patient, acute respiratory occlusion in the spine position can be a life-threatening complication during general anesthesia. We describe a 17-year-old man whose cardiac tamponade was treated by pericardial-pleural window through a left anterior thoracotomy in the lateral position. The patient recovered from hemodynamic compromise without showing respiratory occlusion during general anesthesia and remained in the lateral position until extubation. Pathological diagnosis was precursor T-lymphoblastic lymphoma. There were no complications attributable to the operative procedure. Further chemotherapy reduced the mediastinal mass in size after two weeks when the patient developed sepsis and died. Lateral position prevents respiratory occlusion during surgical procedure under general anesthesia in the patient of huge anterior mediastinal tumor with airway obstruction.
authors.affiliation: Department of Cardiovascular Surgery, Hiratsuka City Hospital, 1-19-1 Minamihara, Hiratsuka, Kanagawa 254-0065, Japan.
authors.forename: Yasunori
authors.initials: Y
authors.lastname: Cho
authors.forename: Satoru
authors.initials: S
authors.lastname: Suzuki
authors.forename: Masakazu
authors.initials: M
authors.lastname: Yokoi
authors.forename: Muneaki
authors.initials: M
authors.lastname: Shimada
authors.forename: Saburo
authors.initials: S
authors.lastname: Kuwabara
authors.forename: Akira
authors.initials: A
authors.lastname: Murayama
mesh_terms: D000293:Adolescent; D000402:Airway Obstruction / Q000517:prevention & control*; D000768:Anesthesia, General; D002305:Cardiac Tamponade / Q000209:etiology / Q000601:surgery*; D017809:Fatal Outcome; D006801:Humans; D007442:Intubation, Intratracheal; D008297:Male; D008479:Mediastinal Neoplasms / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D011187:Posture; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications / Q000601:surgery*; D014057:Tomography, X-Ray Computed