title: [Anesthesia in a Patient with Giant Goiter in Whom Tracheotomy Was Performed with Standby of Percutaneous Cardiopulmonary Support].
abstract: In a 53-year-old female patient total thyroidectomy for a giant goiter under general anesthesia was scheduled. On talking, airway stenosis sounds were heard. Cervical to thoracic CT revealed left and right lobe tumors measuring 5.3 x 5.6 x 10.0 and 9.1 x 8.6 x 10.0 cm, respectively. The trachea showed stenosis at a site 3.8 to 6.5 cm below the glottis, and the narrowest lumen diameter was 3.1 mm. Due to marked tracheal stenosis, awake intubation was not selected. To maintain the airway, tracheotomy was performed under local anesthesia. Considering the risk of difficulty in ventilation during tracheostomy, 4 Fr catheter sheaths were inserted into the right femoral artery and vein for percutaneous cardiopulmonary support (PCPS). Subsequently, tracheotomy was conducted in an area peripheral to the site of stenosis. After tracheotomy, general anesthesia was started. During general anesthesia, there were no problems regarding ventilation. The tracheal cannula was removed 7 days after surgery, and the patient was discharged after 14 days. For general anesthesia in patients with giant goiter, it is important to select an airway management method in consideration of tumor-related compression of the trachea. Airway management by tracheotomy under local anesthesia with standby of PCPS may be a treatment option.
authors.forename: Tomoki
authors.initials: T
authors.lastname: Ishikawa
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Shin
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Mieda
authors.forename: Naoya
authors.initials: N
authors.lastname: Kawanoue
authors.forename: Mizue
authors.initials: M
authors.lastname: Ishii
authors.forename: Etsu
authors.initials: E
authors.lastname: Iwasaki
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kobayashi
authors.forename: Satoru
authors.initials: S
authors.lastname: Oku
authors.forename: Takeshi
authors.initials: T
authors.lastname: Mikane
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Tokioka
mesh_terms: D058109:Airway Management / Q000379:methods; D000758:Anesthesia / Q000379:methods*; D005260:Female; D006042:Goiter / Q000601:surgery*; D006801:Humans; D008875:Middle Aged; D013965:Thyroidectomy; D014140:Tracheotomy