I would try to improve the condition of this patient preoperatively-infusions,correction of anaemia,adequate intravascular volume,  Echo-find out ejection fraction,pulmonary hypertension,valve function. In case of severe heart depression,CT brain -acute ischaemia,I would refuse the case. In case I would anesthetize this patient, I would discuss risk of this procedure with his family- highrisk patient, very old, complications including death. I would prefer epidural with placing catheter-unnecessary adequate iv volume.

Thanks for answer, this I have not known so far :)

Hello,
I would like to ask about your practice of extubation following total gastrectomy. During this procedure of course gets some GIT content up to mouth. Do you feel ,frequent missed microaspirations of this content in yet intubated patient occur?How do you prevent aspiration?
How do you proceed,if a distal part of oesophagus is also resected and in the end of surgery you change from double-lumen endotracheal tube to single lumen one?
Do you experience more respirátory complications following this procedure?
Thanks very much for your answers  Frank