[Anesthetic Management of the Patient with an Anterior Mediastinal Tumor].

Perioperative management of the patient with anterior mediastinal tumor is challenging and should not be underestimated. The clinical presentation of the patient is variable because it depends on the size and localiza- tion of the tumor. Therefore, it is difficult to establish a structured protocol for anesthetic management of ante- rior mediastinal tumor. Anesthesiologists are required to make careful anesthetic plan with thorough assessment of preoperative status of the patient Confirmation of "comfortable position" for the patient is important and useful for safe management The induction of general anesthesia should be performed in step-by-step wise without muscle relaxants. Even after successful tracheal intubation, difficult ventilation may occur. Preparation of percutaneous cardiopulmonary support (PCPS) is essential for the emergency situation from both respiratory and circulatory collapses, especially during anesthesia induction. For emergency use of PCPS, cannulation of femoral vessels under local anesthesia should be performed before anesthesia induction in the patient with subjective respiratory symptom and severe tracheal compression.