Tracheal injury diagnosed by a sudden increase in end-tidal carbon dioxide levels during mediastinoscopic subtotal esophagectomy: a case report.

IF 0.8 Q3 ANESTHESIOLOGY

JA Clinical Reports Pub Date : 2024-02-13 DOI:10.1186/s40981-024-00695-3

Natsuho Haraguchi, Yoshifumi Naito, Masayuki Shibasaki, Teiji Sawa

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引用次数: 0

Abstract

Background: Mediastinoscopic surgery for esophageal cancer facilitates early postoperative recovery. However, it can occasionally cause serious complications. Here, we present the case of a patient with a tracheal injury diagnosed by a sudden increase in end-tidal carbon dioxide (EtCO₂) during mediastinoscopic subtotal esophagectomy.

Case presentation: A 52-year-old man diagnosed with esophageal cancer was scheduled to undergo mediastinoscopic subtotal esophagectomy. During the mediastinoscopic procedure, the EtCO₂ level suddenly increased above 200 mmHg, and the blood pressure dropped below 80 mmHg. We immediately asked the operator to stop insufflation and found a tracheal injury on the right side of the trachea near the carina by bronchoscopy. The endotracheal tube was replaced with a double-lumen tube, and the trachea was repaired via right thoracotomy. There were no further intraoperative complications. After surgery, the patient was extubated and admitted to the intensive care unit.

Conclusions: Monitoring EtCO₂ levels and close communication with the operator is important for safely managing sudden tracheal injury during mediastinoscopic esophagectomy.

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纵隔镜下食管次全切除术中潮气末二氧化碳浓度突然升高导致气管损伤：病例报告。

背景：纵隔镜手术治疗食管癌有利于术后早期恢复。然而，它偶尔也会引起严重的并发症。在此，我们介绍了一例在纵隔镜食管次全切除术中因潮气末二氧化碳（EtCO2）突然升高而被诊断为气管损伤的患者：一名被诊断患有食管癌的 52 岁男子计划接受纵隔镜下食管次全切除术。在纵隔镜手术过程中，EtCO2 水平突然升至 200 mmHg 以上，血压降至 80 mmHg 以下。我们立即要求操作员停止充气，并通过支气管镜检查发现气管右侧靠近心窝处有一处气管损伤。我们用双腔管替换了气管导管，并通过右胸腔切开术修复了气管。术中未再出现并发症。术后，患者拔管并进入重症监护室：结论：在纵隔镜食管切除术中，监测EtCO2水平并与操作者密切沟通对于安全处理突发性气管损伤非常重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

JA Clinical Reports ANESTHESIOLOGY-

CiteScore

1.30

自引率

0.00%

发文量

审稿时长

9 weeks

期刊介绍： JA Clinical Reports is a companion journal to the Journal of Anesthesia (JA), the official journal of the Japanese Society of Anesthesiologists (JSA). This journal is an open access, peer-reviewed, online journal related to clinical anesthesia practices such as anesthesia management, pain management and intensive care. Case reports are very important articles from the viewpoint of education and the cultivation of scientific thinking in the field of anesthesia. However, submissions of anesthesia research and clinical reports from Japan are notably decreasing in major anesthesia journals. Therefore, the JSA has decided to launch a new journal, JA Clinical Reports, to encourage JSA members, particularly junior Japanese anesthesiologists, to publish papers in English language.