Akademik Veri Yönetim Sistemi
6th INTERNATIONAL ZEUGMA CONFERENCE ON SCIENTIFIC RESEARCHES, Gaziantep, Türkiye, 19 - 20 Haziran 2021, ss.27-28
Abstract
Background: Tracheal stenosis is an important complication of long-term intubation or
tracheostomy. Tracheal resection with end-to-end anastomosis is an effective surgical method.
Although it is frequently applied to adult patients, pediatric patients are limited in the
literature. We aimed to investigate the anesthetic management of a 1-year-old child during
tracheal resection.
Materials and methods: A 1-year-old male patient had an inguinal hernia operation at the
age of 20 days and liver transplantation at the age of 5 months. Tracheostomy was performed
considering laryngomalacia at the postoperative period after transplantation surgery. In the
follow-up with silver cannula, tracheal stenosis was diagnosed due to respiratory problems
and tracheal resection surgery was planned.
Results and discussion: Patient with tracheostomy was monitored using noninvasive blood
pressure, pulse oximetry, ECG; temperature and capnography was added after intubation.
Anesthesia was induced via tracheostomy cannula with sevoflurane in 50%+%50 N2O+
O2. After anesthesia induction, rocuronium bromide was administered. Anesthesia was
maintained with sevoflurane %1-2 and 50%+%50 N2O+O2. Tracheostomy area was debrided
with collar incision, sterile intubation tube was inserted through the distal tip of the tracheal
incision, sterile anesthesia circuit was attached, and ventilation was started in this way.
Approximately 2 cm of trachea was resected. After the posterior trachea was anastomosed
end-to-end, the patient was intubated orally endotracheal tube and sterile tube was removed.
Tracheal anastomosis was completed after observing oral intubation tube crossed the
anastomosis line. All layers were closed after controlling for air leakage, foreign body and
bleeding. The surgery was terminated after stability of the anastomosis line was seen with
rigid bronchoscopy. Intravenously morphine 1 mg and paracetamol 150 mg were given for
postoperative analgesia. The patient was taken to the pediatric intensive care unit for
postoperative follow-up. He was extubated on the 10th postoperative day and taken to the
ward room on the 14th postoperative day. Patient was discharged on the 17th day of
hospitalization without any problems.
Conclusion: Tracheal resection with end-to-end anastomosis can be performed safely in
pediatric patients as in adults. Close communication with the surgical and anesthesia team
increases success of the surgery.
Key words: tracheal resection, anastomosis, child