H Nomori1, H Horio, K Suemasu. 1. Department of Thoracic Surgery, Saiseikai Central Hospital, Tokyo, Japan.
Abstract
BACKGROUND: Dumon stent placement requires use of a technically difficult rigid bronchoscope. A recently developed technique for placing a Dumon stent introduced via a conventional endotracheal tube is detailed herein. METHODS: The conventional endotracheal tube is inserted beyond the stenosis site; this procedure is observed with the use of a flexible bronchoscope with the patient undergoing general anesthesia. The Dumon stent is folded and inserted into the endotracheal tube and is introduced into the stenosis site with the use of a cylindrical-tipped stainless steel wire as a pusher. The endotracheal tube is withdrawn while the pusher is positioned to expand the stent at the stenosis site. Dumon stents of 12 to 16 mm in diameter were put in place using the present method in 5 cases of tracheobronchial stenosis. RESULTS: The mean time from endotracheal tube insertion to stent placement was 181 s. The present method positioned the Dumon stent more easily and safely than the original rigid bronchoscope because the endotracheal tube used was flexible. One patient, however, required a tracheostomy and surgical forceps to remove the stent 3 months after placement. CONCLUSION: While Dumon stent removal may require a rigid bronchoscope or tracheostomy, stents can be introduced without difficulty via a conventional endotracheal tube.
BACKGROUND: Dumon stent placement requires use of a technically difficult rigid bronchoscope. A recently developed technique for placing a Dumon stent introduced via a conventional endotracheal tube is detailed herein. METHODS: The conventional endotracheal tube is inserted beyond the stenosis site; this procedure is observed with the use of a flexible bronchoscope with the patient undergoing general anesthesia. The Dumon stent is folded and inserted into the endotracheal tube and is introduced into the stenosis site with the use of a cylindrical-tipped stainless steel wire as a pusher. The endotracheal tube is withdrawn while the pusher is positioned to expand the stent at the stenosis site. Dumon stents of 12 to 16 mm in diameter were put in place using the present method in 5 cases of tracheobronchial stenosis. RESULTS: The mean time from endotracheal tube insertion to stent placement was 181 s. The present method positioned the Dumon stent more easily and safely than the original rigid bronchoscope because the endotracheal tube used was flexible. One patient, however, required a tracheostomy and surgical forceps to remove the stent 3 months after placement. CONCLUSION: While Dumon stent removal may require a rigid bronchoscope or tracheostomy, stents can be introduced without difficulty via a conventional endotracheal tube.