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[Dumon stent placement via endotracheal tube]
Abstract:
We conducted a Dumon stent placement via endotracheal tube for 10 patients with airway stenosis. The conventional endotracheal tube is inserted beyond the stenosis site; this procedure is conducted with the use of a flexible bronchoscope under general anesthesia. The Dumon stent is folded and inserted into the endotracheal tube and is then introduced into the stenosis site with the use of a cylindrical-tipped stainless steel wire as a pusher. Although the Dumon stents were placed using a rigid bronchoscope for the first 7 patients, the present procedure was used for the latest 10 patients. Compared with the rigid bronchoscope technique, this procedure is suitable for the placement of a larger stent for a shorter time. It has the following advantages over the rigid bronchoscope technique: (1) the use of an endotracheal tube and flexible bronchoscope makes the stent placement easier for the practitioner and less stressful for the patient; (2) because of the flexibility of the endotracheal tube, a Dumon stent can be placed easily, even in the left main bronchus or in a markedly shifted trachea or bronchus, and also in a patient who has difficulty in expanding the neck; (3) a stent can be placed safely in a patient with severe tracheal stenosis and orthopnea. The present procedure does, however, have the disadvantage that it is difficult to control the direction of the tip of the endotracheal tube. We concluded that the present procedure could be a useful method for Dumon stent placement.