Situation
1 A patient with a previous tracheostomy is listed for a thoracotomy. What is going through your mind ?
2 A patient with an end tracheostomy, 15 years ago for carcinoma of the larynx is listed for thoracotomy. What is going through your mind ?
1 Make sure you exclude tracheal stenosis or malacia via bronchoscopy preoperatively.
2 With a permanent tracheostomy beware of no intrinsic PEEP and a poor cough, especially in pneumonectomy patients.