Tracheal resection: the team brief in multi-stage airway surgery.

Abstract

The multidisciplinary team brief and effective clinical decision-making are critical to airway surgery. To illustrate this, we present the case of a 58-year-old female with papillary thyroid cancer invading the trachea. We describe a basic framework that was used to aid planning the management of this patient. Tracheal resection is a complex airway operation requiring the evaluation of airway obstruction risk, the formulation of strategies for complex airway management and lung ventilation during complete resection of the tracheal segment and a handover plan for safe tracheal extubation. We suggest that team performance is facilitated by a standardised structure for consideration of anticipated events and important decisions to be made before the operation. Furthermore, it can provide a platform to engage the team when unanticipated events occur and alternate plans have to be made in a time-critical manner.