Anesthetic challenges in tracheal resection: A case series on fast track extubation with cross-field ventilation for patients undergoing tracheoplasty

Tracheal resection and anastomosis present significant anesthetic challenges owing to the shared airway and surgical field between the anesthesiologist and the surgeon. Ensuring adequate ventilation while maintaining optimal surgical access requires meticulous planning and coordination. This case series describes four patients who underwent tracheal resection and anastomosis, where distal tracheal intubation with cross-field ventilation was employed to maintain oxygenation during airway transection and reconstruction. Fast-track extubation in the operating room was successfully achieved in all cases to minimize airway trauma and promote early recovery. Perioperative anesthetic strategies were individualized according to patient anatomy, lesion location, and associated comorbidities. The use of cross-field ventilation provided effective control over airway dynamics and minimized the risk of hypercapnia during tracheoplasty. This experience highlights the importance of individualized anesthetic planning, precise airway management, close interdisciplinary collaboration, and timely extubation to ensure optimal outcomes in patients undergoing tracheal surgery.