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Extracorporeal oxygenation support for curative surgery in a patient with papillary thyroid carcinoma invading the trachea

Published online by Cambridge University Press:  23 September 2008

H-K Jeon
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
Y K So
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
J-H Yang
Affiliation:
Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
H-S Jeong*
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
*
Address for correspondence: Dr Han-Sin Jeong, Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ir-Won Dong, Kang-Nam Gu, Seoul, 135-710, South Korea. Fax: 82 2 3410 6987 E-mail: hansin.jeong@samsung.com

Abstract

Objective:

Local extension of thyroid carcinoma can result in massive invasion of the trachea, causing severe airway compromise. The pre- and peri-operative management of such airway compromise is difficult but critical. We report the use of extracorporeal oxygenation support as an alternative peri-operative airway management option in such a situation. This approach facilitated curative surgery in a patient with papillary thyroid carcinoma invading the trachea.

Method:

We present a case report regarding extracorporeal oxygenation support in a patient with locally advanced thyroid carcinoma.

Results:

The patient was a 68-year-old woman with aggressive thyroid papillary carcinoma invading the trachea. The airway was almost totally obstructed, and tracheal resection and end-to-end anastomosis was planned. A venovenous bypass catheter was placed for cardiopulmonary bypass, using the bilateral femoral veins. Curative surgery and reconstruction were then performed successfully, under general anaesthesia assisted by cardiopulmonary bypass oxygenation.

Conclusion:

Cardiopulmonary bypass oxygenation is a safe and effective alternative airway management option in patients with locally aggressive thyroid cancer.

Type
Clinical Records
Copyright
Copyright © JLO (1984) Limited 2008

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