[Resection of tracheal carcinoma using partial cardiopulmonary bypass--report of a case]

A 43-year-old male was admitted to our hospital with chief complaints of stridor and dyspnea. Bronchoscopy revealed a tumor obstructing almost the whole lumen of the trachea. As it was impossible to insert an endotracheal tube into the distal site of the stenosis in the mediastinum, we used partial cardiopulmonary bypass to maintain gas exchange. The axillary artery and the femoral artery and vein were cannulated for the bypass using local anesthesia. During 105 minutes of bypass, the PaO2 value was good but the PaCO2 value increased up to 70 mmHg. After the trachea was opened, the anesthetic gas was administered across the operative field through the endotracheal tube and the cardiopulmonary bypass was discontinued. Tracheolaryngectomy and permanent tracheostomy with relocation to the right and caudal side of the brachiocephalic artery was performed successfully. The post operative course was very smooth. The patient has been well for 6 months since the surgery. Partial cardiopulmonary bypass proved to be useful for maintaining gas exchange during reconstructive surgery of the trachea. We treated a case of tracheal carcinoma by resection while using partial cardiopulmonary bypass. We believe this is the ninth such case reported Japanese literature.