Lucknow: Doctors at Apollo Medics Super Speciality Hospital have successfully performed a complex thyroid cancer surgery on a 70-year-old man whose tumour had severely compressed his windpipe, making conventional anaesthesia and intubation extremely difficult.
The rare procedure involved a coordinated effort by the surgical oncology, cardiac surgery and anaesthesia teams, with the patient placed on peripheral cardiopulmonary bypass (CPB), commonly known as a heart-lung machine, to maintain blood circulation and oxygen supply while securing the airway.
Doctors said the cancerous mass had spread across the front and both sides of the neck and was exerting significant pressure on the trachea. Attempts to secure the airway through conventional intubation, including bronchoscopy-assisted methods, were unsuccessful. Since the cancer was confined to the neck and had not spread to other parts of the body, surgery was considered necessary.
The patient was placed on CPB through the femoral artery and vein. Spinal anaesthesia was used initially, while the heart-lung machine maintained circulation and oxygenation. As conventional airway management remained impossible, the surgical oncology team performed a subglottic tracheostomy below the tumour during CPB support, creating an alternative airway and inserting a tube.
Once the airway was secured, the patient was weaned off the heart-lung machine and the thyroid surgery was completed. The procedure lasted around four-and-a-half to five hours and was completed without excessive blood loss. The patient was subsequently shifted to the ICU for monitoring and was reported to be recovering well.
The medical team described the procedure as thyroidectomy with CPB support, a rarely required approach in such cases.
Dr Tarun Batra, Director, Surgical Oncology, said the tumour made a conventional tracheostomy impossible and that creating an airway below the tumour, with coordinated support from the cardiac and anaesthesia teams, was crucial.
Dr Bharat Dubey, Director, Cardiac Surgery, said the primary challenge was maintaining a secure airway and adequate oxygenation in view of the severe tracheal compression.
Dr Mayank Somani, MD and CEO, Apollo Medics Super Speciality Hospital, highlighted the role of multidisciplinary coordination and said the availability of specialised teams and facilities under one roof enabled the complex procedure to be completed at the hospital.
