title: Surgical management of tracheal compression caused by mediastinal goiter: is extracorporeal circulation requisite?
abstract: OBJECTIVE
  To investigate the surgical and anesthetic management strategy of tracheal compression caused by mediastinal goiter.
  
  
  METHODS
  We retrospectively analyzed a patient with an anterior mediastinal mass in whom cardiopulmonary bypass was kept on standby via femoral vessels before induction of anesthesia. Bronchoscope guided tracheal intubation was done and tumor was removed via a cervical approach. Relative literature was reviewed.
  
  
  RESULTS
  CPB via femoral vessels before induction of anesthesia help the patient recover from the perioperative period safely. While bronchoscope slipped beyond the obstruction smoothly and spent less time. The apparently narrow trachea easily distended and did not impair passage of the tube into the trachea opposed to being predicted preoperatively. The histopathological diagnosis confirmed the tumor as a nodular goiter with the formation of hematoma.
  
  
  CONCLUSIONS
  CPB via femoral vessels before induction of anesthesia during surgical management of tracheal compression caused by mediastinal goiter is justified while bronchoscope guided tracheal intubation to establish the tracheal patency is a safe and feasible alternative.
authors.affiliation: Department of General Thoracic Surgery (Drs Wang, Lin, Yang and Wang), Second Affiliated Hospital, Medical College of Ji'nan University , Shenzhen People's Hospital, Shenzhen518020, Guangdong Province, China; Department of Cardiovascular Surgery (Dr Sun), Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, Hubei Province, China.
authors.forename: Guangsuo
authors.initials: G
authors.lastname: Wang
authors.forename: Shaolin
authors.initials: S
authors.lastname: Lin
authors.forename: Lin
authors.initials: L
authors.lastname: Yang
authors.forename: Zheng
authors.initials: Z
authors.lastname: Wang
authors.forename: Zongquan
authors.initials: Z
authors.lastname: Sun