Radical esophagectomy for esophageal cancer with a bronchial occluder placed within a tracheotomy trocar: a case report

Background: Radical surgery for esophageal cancer frequently necessitates the use of pulmonary isolation techniques during general anesthesia. However, the airway management of patients with esophageal cancer who undergo this procedure with a combined tracheotomy is undoubtedly challenging and difficult for anesthesiologists. In this case report, we describe the case of a patient who was retained with a tracheotomy metal cannula in place following radical surgery for tongue root cancer. The anesthetic management strategy used for this patient provides a new concept for anesthesiologists to implement lung isolation techniques when encountering this type of patient to improve airway management. Case Presentation: The patient was a 68-year-old male who had experienced a choking sensation for over a month without any discernible triggers. Two years previously, he underwent a radical surgical procedure and tracheotomy for cancer of the tongue root; this was followed by postoperative radiotherapy and the insertion of a tracheotomy metal cannula. Gastroscopy revealed an irregular neoplasm located 38 cm from the central incisor, and a biopsy indicated squamous cell carcinoma. Based on these findings, the patient was diagnosed with esophageal malignancy. Radical surgery for esophageal cancer was planned under general anesthesia. Following the surgical procedure, the patient demonstrated a favorable recovery trajectory following a series of adjuvant therapies. The patient was subsequently discharged from the Department of Medical Oncology following the completion of related treatments. Conclusion: The placement of a bronchial occluder into the tracheotomy tube represents a simple, effective, and less invasive method of airway management when performing pulmonary isolation techniques for tracheotomized patients under general anesthesia. However, the safety and standardization of this method still require validation through further clinical practice.