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Anesthesia for airway endoscopic recanalisation with selfexpanded stents


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Abstract

Tracheal and bronchial endoscopic stenting can give a quick therapeutic result or delay surgical treatment of patients with stenosis. It also can improve quality of life, create conditions for palliative therapy and increase survival of incurable oncological patients. This paper contains description of our experience in anesthesia for tracheal stenting with respiratory support. Materials and methods: 23 patients were investigated retrospectively (15 males, 8 females). They had 28 interventions under general anesthesia. 14 patients had malignant and 9 had non-malignant lesions. Complicated somatic status, stenosis extention and localization, type of laryngoscope, unprotected airways determined choice of intravenous anesthesia with high-frequency ventilation and muscle relaxation. Results: Improvement (dyspnea decreasing) was mentioned in 78,3% (18/23) cases after stenting, in 8,7% (2/23) cases improvement was slight; in 4,3% (1/23) cases - no change; in 8,7% (2/23) cases patients died. Complications after stenting occurred in 10 cases (43,5%). In 4 cases (17,4%) - stent displacement; in 2 cases (8,7%) - purulent tracheobronchitis; in 1 case (4,35%) - paroxysmal cough with pain. In 1 case loss of stent during paroxysmal cough and vocal cords edema occurred. In 2 cases (8,7%) operation was failed and patients died due to the lesion progression and respiratory insufficiency. Conclusions: Anesthetic protection is an important component at endoscopic recanalization with selfexpanded stents. Management is difficult due to complicated somatic status, and unprotected airways. Significant health enhancement, dyspnea decreasing even by exercise stress justified high anesthetics risks.


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