Anaesthetic management for pulmonary bilobectomy in a patient with previous contralateral lobectomy and total laryngectomy with tracheostomy.

Pulmonar lobectomy by video-assisted thoracoscopic surgery (VATS) usually requires collapse of the operative lung and ventilation of the contralateral lung only. The complexity of anaesthetic management in such procedures is further increased by patient comorbidities and previous pathologies. We report the case of a patient scheduled for right lower lobectomy by VATS with a history of previous left lower lobectomy and total laryngectomy with permanent tracheostomy after a glottic carcinoma. A left-sided double-lumen tube was used in combination with a bronchial blocker in order to allow selective ventilation of the right upper lobe should intraoperative hypoxaemia occur.