Hello. 
My name is Stefano  and i writes from Italy. 
First of all sorry for my english.
I would want to introduce a problem. 
In my unit of intensive therapy, a patient of 42 years with massive stenosis of the trachea has been admitted 8 days ago. 

She had been admitted in urgency in operating room of thoracic surgery for removal of the stenosis due to tracheal intraluminal tumor.

This nodule is found at the level of first segment of intrathoracic  trachea. 

During the removal laser surgery,  the patient accused serious respiratory insufficiency and readly was intubate and assisted with mechanical ventilation. 

Then she was transferred in unit of intensive therapy for mechanical ventilation and stabilization. 

The thoracic surgeon has practiced after 5 days a surgical tracheostomy with a long tube whose extremity ends under the stenosis, but he has not removed the tumor that obstructs nearly the 100% of tracheal lumen.


He has also programmed for the next days a new surgery with the laser.


How do  you suggest  to carry out the respiratory and anaesthesiological management, considerating the fact that the surgeon would operate with the great possible space in trachea. 

I would have to be equipped for extracorporeal circulation? 


Whichever council is welcome.

Thanks

Stefano Soriano
Italy

Sorry for my bad english :-)