Kauvery Hospital, Salem, has once again demonstrated its clinical excellence and leadership in complex airway and thoracic surgeries by successfully saving the life of a 60-year-old male patient who was admitted in a critical condition with severe respiratory distress.

Kauvery Hospital, Salem

The patient was first evaluated by the Department of Pulmonology nearly a year ago, when a CT scan revealed a tumour completely obstructing the left main bronchus, preventing airflow to the left lung. Despite medical advice, the patient did not continue further treatment. Approximately one year later, he returned to the hospital with markedly worsened breathing difficulty and was in a life-threatening condition.

A repeat CT scan showed significant progression of the tumour, with extension into the trachea, dangerously narrowing the central airway responsible for supplying air to both lungs. At this advanced stage, even a minimal delay could have resulted in complete airway obstruction and respiratory failure.

As an emergency measure to relieve the obstruction, Dr. Ramachandran, Pulmonologist, performed a bronchoscopy procedure. However, the tumour was found to be highly vascular, making complete bronchoscopy removal extremely risky due to the potential for massive bleeding into the only functioning lung—the right lung. To stabilize the patient temporarily, ventilation to the right lung was secured under bronchoscopy guidance.

Recognizing the gravity of the situation, a multidisciplinary team comprising Dr. Naveen Chandar and Dr. Niranjan (Cardiothoracic Surgeons), Dr. Rajkumar (Surgical Oncologist), and Dr. Ramachandran (Pulmonologist) convened for urgent deliberation. The team unanimously concluded that a Left Pneumonectomy-complete removal of the affected lung along with the tumour-was the only definitive and life-saving option.

The surgery presented multiple challenges. Due to extensive involvement of the central airway, airway management during anaesthesia was exceptionally complex. The anaesthesia team, led by Dr. Saravana Kumar, Consultant Anaesthesiologist, carefully advanced the endotracheal tube beyond the narrow margin of the tumour with extreme precision. Even minimal trauma could have resulted in catastrophic bleeding or complete airway collapse.

During the procedure, surgeons meticulously removed the portions of the tumour extending into the central airway without opening the trachea, employing advanced surgical techniques and exceptional precision. Despite extensive disease involvement, the tumour and the left lung were removed successfully, with careful preservation of vital blood vessels and restoration of airway integrity, all without significant blood loss.

Postoperatively, the patient showed immediate improvement in breathing and continued to recover steadily. He was subsequently discharged from the hospital in a stable condition with significant clinical improvement.

This complex surgery was possible because of our team’s seamless coordination, technical expertise, and unwavering commitment to patient safety.

This case stands as a strong testament to Kauvery Hospital, Salem’s expertise in managing rare and highly complex airway and lung tumours, further reinforcing its position as a trusted centre for advanced and emergency healthcare services.