Abstract：
BACKGROUND: It is uncommon to perform liver transplantation for patients with end-stage liver disease having tracheostomy. Usually, the tracheostomy cannula is changed to an oral endotracheal tube (ETT) before operation because ETT is easy to handle during operation. If routine oral ETT insertion is difficult, we should seek other solutions.
METHODS: We report a successful conversion from tracheostomy tube to ETT in a patient with subglottic stenosis. The patient was an 8-month-old infant who was scheduled for living donor liver transplantation due to acute hepatic failure. The original plan was to convert the tracheostomy tube to oral ETT, which failed due to aggravation of subglottic stenosis. An otolaryngologist performed balloon dilatation surgery, and ETT was successfully intubated. Owing to a multidisciplinary approach, the surgery was successfully performed without fatal adverse events, and the patient was later discharged with a tracheostomy.
CONCLUSIONS: It is unusual for pediatric patients with tracheostomy tubes to undergo major surgeries like liver transplantation. We hope that this case of successful anesthetic management based on a multidisciplinary approach suggests new ideas to anesthesiologists seeking safe anesthesia.
METHODS: We report a successful conversion from tracheostomy tube to ETT in a patient with subglottic stenosis. The patient was an 8-month-old infant who was scheduled for living donor liver transplantation due to acute hepatic failure. The original plan was to convert the tracheostomy tube to oral ETT, which failed due to aggravation of subglottic stenosis. An otolaryngologist performed balloon dilatation surgery, and ETT was successfully intubated. Owing to a multidisciplinary approach, the surgery was successfully performed without fatal adverse events, and the patient was later discharged with a tracheostomy.
CONCLUSIONS: It is unusual for pediatric patients with tracheostomy tubes to undergo major surgeries like liver transplantation. We hope that this case of successful anesthetic management based on a multidisciplinary approach suggests new ideas to anesthesiologists seeking safe anesthesia.
摘要：
背景：对于有气管造口术的终末期肝病患者进行肝移植并不常见。通常,术前气管造口套管改为经口气管导管（ETT），因为ETT在手术过程中易于操作。如果常规口服ETT插入困难，我们应该寻求其他解决方案。
方法：我们报告了声门下狭窄患者从气管造口管成功转换为ETT。该患者是一名8个月大的婴儿，由于急性肝衰竭而计划进行活体供体肝移植。最初的计划是将气管切开管转换为口服ETT，由于声门下狭窄加重而失败。一位耳鼻喉科医生做了球囊扩张手术，ETT插管成功。由于采取了多学科的方法，手术成功进行，没有致命的不良事件，病人后来用气管造口术出院。
结论：对于气管切开导管的儿科患者来说，进行像肝移植这样的大手术是不寻常的。我们希望基于多学科方法的成功麻醉管理案例为寻求安全麻醉的麻醉医师提供新的思路。
方法：我们报告了声门下狭窄患者从气管造口管成功转换为ETT。该患者是一名8个月大的婴儿，由于急性肝衰竭而计划进行活体供体肝移植。最初的计划是将气管切开管转换为口服ETT，由于声门下狭窄加重而失败。一位耳鼻喉科医生做了球囊扩张手术，ETT插管成功。由于采取了多学科的方法，手术成功进行，没有致命的不良事件，病人后来用气管造口术出院。
结论：对于气管切开导管的儿科患者来说，进行像肝移植这样的大手术是不寻常的。我们希望基于多学科方法的成功麻醉管理案例为寻求安全麻醉的麻醉医师提供新的思路。
