Robot-assisted thoracoscopic tracheal carina resection and reconstruction under spontaneous-ventilation anesthesia with a single-lumen endotracheal tube: case report and literature review
Abstract
Background: Robot-assisted thoracoscopic carina resection and reconstruction using non-intubated laryngeal mask airway with spontaneous ventilation has been reported. However, no cases have been described using a single-lumen endotracheal tube under spontaneous-ventilation anesthesia. We report a case of a patient who developed carinal malignancy two years after right middle and lower lobectomy for lung cancer. He underwent robot-assisted carina resection and reconstruction under spontaneous-ventilation anesthesia via single-lumen endotracheal intubation.
Case presentation: A 58-year-old male presented with a malignant tracheal carina tumor, complaining of bloody sputum and progressive dyspnea. Chest computed tomography (CT) and bronchoscopic biopsy confirmed squamous cell carcinoma. The patient had undergone right middle and lower lobectomy for squamous cell carcinoma (pT2bN0M0) two years prior. Current diagnosis was local recurrence with 90% carinal obstruction. After two cycles of chemoimmunotherapy, his symptoms resolved, and chest CT indicated near-complete remission (cCR). One month post-treatment, he underwent robot-assisted thoracoscopic carina resection under spontaneous-ventilation anesthesia with single-lumen intubation. After anesthesia induction, surface infiltration anesthesia was performed on the glottis, trachea, carina, and main bronchus under the guidance of fiberbronchoscope, and a 7.0# single-lumen tube was placed. Regional block was performed on the…
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