Use of Univent tube for intermittent lung isolation during thoracoscopic mediastinal tracheal resection and reconstruction

RATIONALE Primary tracheal adenoid cystic carcinoma of the trachea primary is a rare neoplasm and commonly misdiagnosed. Lung isolation during surgery and ventilation pose a tremendous challenge to anesthesiologists. PATIENT CONCERNS The authors describe a novel technique of lung isolation and ventilation with a Univent tube during thoracoscopic mediastinal tracheal resection and reconstruction in a female patient. DIAGNOSES Primary tracheal adenoid cystic carcinoma, nonsmall cell carcinoma. INTERVENTIONS In this case, tracheal resection and reconstruction were performed. A bronchial blocker of the Univent tube was used as a guide to manipulate the depth of endotracheal tube. OUTCOMES The intermittent 1-lung ventilation was established successfully. The patient recovered uneventfully and discharged after 10 days. LESSONS The advantages of approach include a stable airway management without occupying the contracted space of thoracoscope and no potential risk of trapping or barotraumas.