Palliative intubation of the tracheobronchial tree

Sixteen patients with far-advanced neoplastic lesions in the trachea and main-stem bronchi were studied. Ten of them were admitted to the ward in extremely poor general condition with marked cyanosis and dyspnea at rest. Palliative intubation was undertaken with two types of tubes: a Neville tracheal prosthesis and a Tracheoflex tracheostomy tube. Both types of tubes had to be specially prepared, as they had originally been designed for other purposes. The tubes were placed in the stenotic sections of the trachea and, depending on anatomical relations, within the right or left main bronchus as well. Intubation of the bronchus in the case of changes involving only the trachea was necessary to properly position and fasten the tube in the bronchial tree and to prevent displacement of the prosthesis inside the trachea. In two patients the esophagus was intubated as well. An improvement in the general condition of all patients was observed. Intubation resulted in reexpansion of a completely collapsed lung in two patients. The longest time of intubation was 9 months. The method is simple, and every physician experienced in endoscopy can use it. The results obtained encourage its further and wider application.