Video-assisted thoracoscopic tracheal tumor resection with acupuncture drug compound non-intubated anesthesia: a case report

Abstract

Background: Primary tracheal tumors are very rare, surgical treatment is the first choice, and the extent of resection and anastomosis is determined by the location, shape and size and pathological result of the tumor. With the rapid development of minimally invasive techniques and instruments in video-assisted thoracoscopic surgery, but tracheal surgery is usually considered to be the most challenging and complex thoracic surgery, which requires not only extraordinary surgical skill, but also good anesthesia management performed by anesthesiologists. Few studies have reported the safety and effectiveness of VATS resection and reconstruction of the tracheal.Case Description: Here we report a case of 47-years female, complaining of cough and short of breath for three months. Bronchoscopy showed a tracheal neoplasm located in the lower trachea, 2 cm away from carina, biopsy result was adenoid cystic carcinoma,and other examinations showed no distant metastasis.After MDT discussion, our surgical team performed 3-port VATS tracheal tumor resection and end-to-end anastomosis with acupuncture drug compound non-intubated anesthesia, our anesthesia team performed spontaneous breathing anesthesia with laryngeal mask to protect the airway, closely observing and prepared for intubation in case of emergency. The patient recovered well with no complication. Conclusion:Our initial experience of VATS tracheal tumor resection and anastomosis with acupuncture drug compound non-intubated anesthesia showed technically safe and feasible. No-intubation anesthesia would reduce damage of the tracheal and ventilator-related lung injury, and acupuncture drug stimulationassisted anesthesia would reduce the dosage of opioids, enhance recovery of patient.