Broad subcutaneous emphysema with airway obstruction during robot‐assisted partial nephrectomy: A case report and literature review
Introduction Subcutaneous emphysema is a relatively common complication in laparoscopic surgery. However, airway obstruction secondary to subcutaneous emphysema is rare. Case presentation A 63‐year‐old woman with a 56‐mm left renal tumor underwent a robot‐assisted partial nephrectomy. The operative...
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| Format: | Article |
| Language: | English |
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Wiley
2023-11-01
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| Series: | IJU Case Reports |
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| Online Access: | https://doi.org/10.1002/iju5.12648 |
| _version_ | 1797627747627958272 |
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| author | Akihiro Ono Masaki Nakamura Tomoe Hayashi Ibuki Tsuru Taro Izumi Masashi Kusakabe Kazunari Nakao Masanori Kashiwagi Haruki Kume Yoshiyuki Shiga |
| author_facet | Akihiro Ono Masaki Nakamura Tomoe Hayashi Ibuki Tsuru Taro Izumi Masashi Kusakabe Kazunari Nakao Masanori Kashiwagi Haruki Kume Yoshiyuki Shiga |
| author_sort | Akihiro Ono |
| collection | DOAJ |
| description | Introduction Subcutaneous emphysema is a relatively common complication in laparoscopic surgery. However, airway obstruction secondary to subcutaneous emphysema is rare. Case presentation A 63‐year‐old woman with a 56‐mm left renal tumor underwent a robot‐assisted partial nephrectomy. The operative time was 155 min, the insufflation time was 108 min, and the estimated blood loss was 70 mL. The pneumoperitoneum pressure was maintained at 12 mmHg, except at 15 mmHg for 19 min during tumor resection. The end‐tidal CO2 was <47 mmHg throughout the procedure. Postoperatively, broad subcutaneous emphysema from the thigh to the eyelid was observed. Computed tomography revealed airway obstruction, and extubation was aborted. On postoperative day 1, emphysema around the trachea and neck improved and the intubation tube was successfully removed. Conclusion Both laryngeal emphysema and physical compression secondary to emphysema can cause airway obstruction. To reduce gas‐related complications, the risk of developing subcutaneous emphysema should be properly assessed during robot‐assisted laparoscopic surgery. |
| first_indexed | 2024-03-11T10:28:42Z |
| format | Article |
| id | doaj.art-874844e29ac04b4ab588eab8da9de205 |
| institution | Directory Open Access Journal |
| issn | 2577-171X |
| language | English |
| last_indexed | 2024-03-11T10:28:42Z |
| publishDate | 2023-11-01 |
| publisher | Wiley |
| record_format | Article |
| series | IJU Case Reports |
| spelling | doaj.art-874844e29ac04b4ab588eab8da9de2052023-11-15T06:01:08ZengWileyIJU Case Reports2577-171X2023-11-016646146410.1002/iju5.12648Broad subcutaneous emphysema with airway obstruction during robot‐assisted partial nephrectomy: A case report and literature reviewAkihiro Ono0Masaki Nakamura1Tomoe Hayashi2Ibuki Tsuru3Taro Izumi4Masashi Kusakabe5Kazunari Nakao6Masanori Kashiwagi7Haruki Kume8Yoshiyuki Shiga9Department of Urology NTT Medical Center Tokyo Tokyo JapanDepartment of Urology NTT Medical Center Tokyo Tokyo JapanDepartment of Anesthesiology NTT Medical Center Tokyo Tokyo JapanDepartment of Urology NTT Medical Center Tokyo Tokyo JapanDepartment of Urology NTT Medical Center Tokyo Tokyo JapanDepartment of Radiology NTT Medical Center Tokyo Tokyo JapanDepartment of Otorhinolaryngology – Head & Neck Surgery NTT Medical Center Tokyo Tokyo JapanDepartment of Anesthesiology NTT Medical Center Tokyo Tokyo JapanDepartment of Urology, Graduate School of Medicine The University of Tokyo Tokyo JapanDepartment of Urology NTT Medical Center Tokyo Tokyo JapanIntroduction Subcutaneous emphysema is a relatively common complication in laparoscopic surgery. However, airway obstruction secondary to subcutaneous emphysema is rare. Case presentation A 63‐year‐old woman with a 56‐mm left renal tumor underwent a robot‐assisted partial nephrectomy. The operative time was 155 min, the insufflation time was 108 min, and the estimated blood loss was 70 mL. The pneumoperitoneum pressure was maintained at 12 mmHg, except at 15 mmHg for 19 min during tumor resection. The end‐tidal CO2 was <47 mmHg throughout the procedure. Postoperatively, broad subcutaneous emphysema from the thigh to the eyelid was observed. Computed tomography revealed airway obstruction, and extubation was aborted. On postoperative day 1, emphysema around the trachea and neck improved and the intubation tube was successfully removed. Conclusion Both laryngeal emphysema and physical compression secondary to emphysema can cause airway obstruction. To reduce gas‐related complications, the risk of developing subcutaneous emphysema should be properly assessed during robot‐assisted laparoscopic surgery.https://doi.org/10.1002/iju5.12648airway obstructionlaparoscopic surgerysubcutaneous emphysema |
| spellingShingle | Akihiro Ono Masaki Nakamura Tomoe Hayashi Ibuki Tsuru Taro Izumi Masashi Kusakabe Kazunari Nakao Masanori Kashiwagi Haruki Kume Yoshiyuki Shiga Broad subcutaneous emphysema with airway obstruction during robot‐assisted partial nephrectomy: A case report and literature review IJU Case Reports airway obstruction laparoscopic surgery subcutaneous emphysema |
| title | Broad subcutaneous emphysema with airway obstruction during robot‐assisted partial nephrectomy: A case report and literature review |
| title_full | Broad subcutaneous emphysema with airway obstruction during robot‐assisted partial nephrectomy: A case report and literature review |
| title_fullStr | Broad subcutaneous emphysema with airway obstruction during robot‐assisted partial nephrectomy: A case report and literature review |
| title_full_unstemmed | Broad subcutaneous emphysema with airway obstruction during robot‐assisted partial nephrectomy: A case report and literature review |
| title_short | Broad subcutaneous emphysema with airway obstruction during robot‐assisted partial nephrectomy: A case report and literature review |
| title_sort | broad subcutaneous emphysema with airway obstruction during robot assisted partial nephrectomy a case report and literature review |
| topic | airway obstruction laparoscopic surgery subcutaneous emphysema |
| url | https://doi.org/10.1002/iju5.12648 |
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