Abstract
Palliative surgery of malignant endobronchial tumours is associated with various anaesthetic risks. A technique is described using a neodymium:yttrium-aluminium-garnet (Nd:YAG) laser in combination with a special tracheoscope and high frequency jet ventilation (HFJV). The purpose of this technique is to provide separation of anaesthetic and surgical manipulations, good conditions of ventilation and easy access to the lungs for the surgeon. We present our experience with 14 adult patients in whom large endobronchial neoplasms were resected using this technique under intravenous anaesthesia and muscle relaxation. Careful perioperative monitoring and a good outcome allowed us to conclude that this set-up may contribute to improving efficiency and safety of endoscopic resections of endobronchial and/or endotracheal tumours.
Abstract
La chirurgie palliative des tumeurs malignes et endonbron-chiques est associée à des risques anesthésiques variés. Une technique est décrite utilisant un laser (Nd:YAG) en combinaison avec un trachéoscope spécial et une ventilation à haute fréquence (HFJV). Le but de cette technique est de fournir une séparation des manipulations anesthésiques et chirurgicales, offrir de bonnes conditions de ventilation et un accès facile aux poumons pour le chirurgien. On présente notre expérience avec 14 patients adulte chez qui des larges tumeurs endobronchiques furent réséquées utilisant cette technique en combinaison avec une anesthésie intraveineuse et une relaxation musculaire. Une surveillance méticuleuse en période périopératoire et des bons résultats nous ont permis de conclure que cette technique peut contribuer à améliorer l’efficacité et la sécurité des résections par endoscopie des tumeurs endobronchiques et/ou endotrachéales.
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Schneider, M., Probst, R. High frequency jet ventilation via a tracheoscope for endobronchial laser surgery. Can J Anaesth 37, 372–376 (1990). https://doi.org/10.1007/BF03005594
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DOI: https://doi.org/10.1007/BF03005594