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Anesthesia for tracheal reconstruction and transplantation

机译：麻醉用于气管重建和移植

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PURPOSE OF REVIEW: Tracheobronchial lesions requiring significant resection of the airway have limited surgical options and present significant obstacles to the anesthesiologist and surgeon. This article will review recent advancements in anesthetic and surgical management. RECENT FINDINGS: Technological advances have introduced novel approaches to the patient with large airway lesions. The use of pump-driven and pumpless extracorporeal life support has rapidly expanded and allow for prolonged periods of apneic airway surgery. Tracheal transplantation has advanced from the cadaveric decellularized scaffolds initially used to true synthetic based structures with autologous stem cell derived epithelium. SUMMARY: Significant leaps in tissue engineered airway transplantation have created curative options for patients previously considered inoperable. These patients pose significant challenges to the anesthesiologist during the entire perioperative period. Close collaboration with surgeons and intensivists and the use of recently developed systems for extracorporeal life support are required.
机译：审查目的：需要对气道进行大面积切除的气管支气管病变的手术选择有限，并且对麻醉师和外科医生提出了重大障碍。本文将回顾麻醉和外科治疗的最新进展。最近的发现：技术进步为患有大气道病变的患者引入了新颖的方法。泵驱动和无泵体外生命支持的使用已迅速扩展，可延长呼吸道呼吸道手术的时间。气管移植已经从最初用于尸体的脱细胞支架发展为具有自体干细胞衍生的上皮的真正基于合成的结构。摘要：组织工程气道移植的重大飞跃为以前认为无法手术的患者提供了治疗选择。这些患者在整个围手术期对麻醉师提出了重大挑战。需要与外科医生和强化医生密切合作，并需要使用最近开发的系统来提供体外生命支持。

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