Airway Management During Tracheal Resection: Intraoperative Retrograde Intubation—A Case Report
Mehtap Tunç1, Esra Onhan Tekoğlu2, Hakan Nomenoğlu3, Göktürk Fındık3, Fatma Yalçın Öztürk1, Ali Alagöz11Department of Anesthesiology and Reanimation, University of Health Sciences, Atatürk Sanatoryum Training and Research Hospital, Ankara, Türkiye2Department of Anesthesiology and Reanimation, University of Health Sciences, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Türkiye
3Department of Thoracic Surgery, University of Health Sciences, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Türkiye
Tracheal stenosis most commonly occurs following prolonged endotracheal intubation or tracheostomy after intensive care treatment. Airway management during tracheal resection is challenging due to changes in airway anatomy and the need to maintain adequate oxygenation and ventilation while preserving the anastomotic line. This case report presents the anesthetic management of a 29-year-old male patient who developed upper tracheal stenosis following prolonged intubation. During tracheal resection surgery, cross-field ventilation via the tracheostomy site was initially used. Since head and neck extension could not be safely performed due to the risk of anastomotic injury, retrograde intubation was performed intraoperatively using a tube-changing catheter. The procedure was successfully completed with a short apnea period and without complications. The patient was safely extubated and discharged on the eighth postoperative day. This case highlights that retrograde intubation can be an effective and safe alternative airway management technique during tracheal resection when conventional intubation methods cannot be applied.
Keywords: Airway management, anesthetic management, thoracic anesthesia, tracheal resection, tracheal stenosis.
Manuscript Language: English