| Abstract: |
Anesthetic management of the individual requiring surgical resection of a portion of the large airways continues to challenge the skills of even the most experienced anesthesiologists. The large airways, including the trachea, carina, and major bronchi, can harbor myriad pathologic conditions that necessitate surgical resection and reconstruction. The patient presenting for airway surgery is often complex medically. Existing disease states frequently contribute to the development of lesions of the large airways. A specific perioperative plan should be developed in concert with the surgical team, including knowledge of the extent and location of the large airway pathology, as well as the planned surgical approach. The degree of existing airway compromise must be anticipated as coordination and sharing of the airway occurs throughout airway resection and reanastomosis. Lastly, emergence and extubation need to be carefully timed. Perioperative care of these patients requires a multidisciplinary team approach and exemplary communication. This chapter will review the etiology of large airway lesions; preoperative evaluation, including pulmonary function testing and radiologic evaluation; and anesthetic management techniques for tracheal resection and reconstruction. Postoperative care of this patient population is discussed. © 2022 Elsevier Inc. All rights reserved. |
