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Perioperative management for placement of tracheobronchial stents

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Abstract

Tracheobronchial stenting was performed under general anesthesia, with (six patients) or without (two patients) muscle relaxant, in eight patients suffering from carcinoma. All patients had presented preoperatively with dyspnea, exhibiting Hugh-Jones grade 4 or 5. Three patients had been mechanically ventilated before the procedure. The procedure was performed under general anesthesia with flexible bronchoscopic guidance. Stent placement was performed either through an orotracheal tube (four patients) or through a transtracheal tube (two patients) in those who had no upper tracheal stenosis, while it was performed through a laryngeal mask airway in two patients with upper tracheal stenosis. During the procedure, arterial hemoglobin oxygen saturation (SpO2) decreased in all patients, despite fraction of inspired oxygen (FIO2) being maintained at 1.0. Except for two patients, one of whom developed superior vena cava syndrome and one, tension pneumothorax after stent placement, there were no complications resulting from stent placement. Six patients were weaned from mechanical ventilation (0–24 days after the procedure). Two of the three patients who had been on mechanical ventilation preoperatively could not be weaned. Stent insertion is an effective treatment for tracheobronchial stenosis, but its indications in patients with malignancy who have been mechanically ventilated prior to stenting should further be evaluated.

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References

  1. CP Sadd S Murthy G Krizmanich AC Mehta (2003) ArticleTitleSelf-expandable metallic airway stents and flexible bronchoscopy Chest 124 1993–1999

    Google Scholar 

  2. ID Conacher (2003) ArticleTitleAnaesthesia and tracheobronchial stenting for central airway obstruction in adults Br J Anaesth 90 367–374 Occurrence Handle10.1093/bja/aeg053 Occurrence Handle1:STN:280:DC%2BD3s%2Fot1KrsQ%3D%3D Occurrence Handle12594151

    Article  CAS  PubMed  Google Scholar 

  3. P Zannini G Melloni G Chiesa A Carretta (1994) ArticleTitleSelf-expandable stent in the treatment of tracheobronchial obstruction Chest 106 86–90 Occurrence Handle1:STN:280:ByuB1M7ktlM%3D Occurrence Handle7517350

    CAS  PubMed  Google Scholar 

  4. M Lippmann L Rome G Eiger DG Wirtshafter JA Oleagea (2002) ArticleTitleUtility of tracheobronchial stents in mechanically ventilated patients with central airway obstruction J Bronchol 9 301–305

    Google Scholar 

  5. JP Shaffer JN Allen (1998) ArticleTitleThe use of expandable metal stents to facilitate extubation in patients with large airway obstruction Chest 114 1378–1382 Occurrence Handle1:STN:280:DyaK1M%2FjvFKhtg%3D%3D Occurrence Handle9824018

    CAS  PubMed  Google Scholar 

  6. GE Wilson MJ Waishaw CR Hind (1996) ArticleTitleTreatment of large airway obstruction in lung cancer using expandable metal stents inserted under direct vision via the fiberoptic bronchoscope Thorax 51 248–252 Occurrence Handle1:STN:280:BymB2cnlt1U%3D Occurrence Handle8779125

    CAS  PubMed  Google Scholar 

  7. T Miyazawa M Yamakido S Ikeda K Furukawa Y Takiguchi H Tada T Shirakusa (2000) ArticleTitleImplantation of ultraflex nitinol stents in malignant tracheobronchial stenoses Chest 118 959–965 Occurrence Handle10.1378/chest.118.4.959 Occurrence Handle1:STN:280:DC%2BD3M%2FisVOlsQ%3D%3D Occurrence Handle11035663

    Article  CAS  PubMed  Google Scholar 

  8. M Unger (1996) ArticleTitleTracheobronchial stents, stunts, and medical ethics revisited Chest 110 1133–1135 Occurrence Handle1:STN:280:ByiD2s3ktl0%3D Occurrence Handle8915205

    CAS  PubMed  Google Scholar 

  9. A Vonk-Noordegraaf PE Postmus TG Sutedja (2001) ArticleTitleTracheobronchial stenting in the terminal care of cancer patients with central airways obstruction Chest 120 1811–1814 Occurrence Handle10.1378/chest.120.6.1811 Occurrence Handle1:STN:280:DC%2BD3MnpsVymug%3D%3D Occurrence Handle11742906

    Article  CAS  PubMed  Google Scholar 

  10. N Tanigawa S Sawada Y Okuda M Sougawa A Komemushi M Kojima Y Hirokawa T Asai (2001) ArticleTitleExpandable metallic stent placement in upper tracheal stenosis: value of laryngeal masks AJR Am J Roentgenol 177 1423–1426 Occurrence Handle1:STN:280:DC%2BD3MnntV2hsQ%3D%3D Occurrence Handle11717099

    CAS  PubMed  Google Scholar 

  11. T Shiraishi T Shirakusa M Hiratsuka S Yamamoto A Iwasaki K Kawahara (2004) ArticleTitleStenting for critical airway stenosis under percutaneous cardiopulmonary support Jpn J Thorac Cardiovasc Surg 52 592–596 Occurrence Handle15651410

    PubMed  Google Scholar 

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Matsuda, N., Matsumoto, S., Nishimura, T. et al. Perioperative management for placement of tracheobronchial stents. J Anesth 20, 113–117 (2006). https://doi.org/10.1007/s00540-005-0379-0

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  • DOI: https://doi.org/10.1007/s00540-005-0379-0

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