Lucknow: Doctors at ApolloMedics Hospital performed a rare, high-risk thyroid cancer surgery on a 70-year-old man after a tumour left his windpipe almost completely blocked, making standard anaesthesia impossible. With conventional intubation and bronchoscopy failing to secure an airway, the team turned to a heart-lung machine to keep the patient oxygenated while surgeons created an alternate breathing passage.The patient’s cancer was confined to the neck and had not spread, so surgery was considered essential. A multidisciplinary team from surgical oncology, cardiac surgery and anaesthesia placed him on peripheral cardiopulmonary bypass (CPB), connecting the machine through the femoral artery and vein to maintain circulation and oxygen delivery.While on CPB, surgeons performed a subglottic tracheostomy, creating an airway below the obstructing tumour, and inserted a breathing tube through the opening. After the airway was secured, the patient was gradually weaned off the heart-lung machine and normal circulation was restored.The team then completed the thyroidectomy in a five-hour procedure without significant blood loss. The patient was shifted to the ICU for monitoring. Director surgical oncology Tarun Batra said a conventional tracheostomy was not possible due to tumour location. Director cardiac surgery Bharat Dubey said CPB was vital during airway access.
