Hori Yoko, Kishikawa Hiroaki, Sakamoto Atsuhiro
Department of Anesthesiology, Nippon Medical School, Sendagi 1-1-5, Bunkyo-ku, Tokyo, 113-8603 Japan.
JA Clin Rep. 2016;2(1):42. doi: 10.1186/s40981-016-0068-z. Epub 2016 Dec 3.
Tracheal stent is a good way to maintain a patent airway in case of stenosis. Although anesthesia techniques for the placement of a stent in the trachea of patients with tracheal stenosis have been reported, the management of general anesthesia in patients with a tracheal stent is not well established.
We report the anesthetic management in the patient with a partly fractured tracheal stent. A 65-year-old man with colon cancer was scheduled for colectomy under general anesthesia. Eight years ago, a tracheal stent was placed because of lung cancer. Preoperative evaluation revealed that a part of the tracheal stent had penetrated the esophagus. We induced general-epidural anesthesia via spontaneous breathing through a laryngeal mask airway to avoid mediastinal emphysema caused by positive pressure ventilation. The patient has been followed up for 2 years without any respiratory complications.
General anesthesia can be safely induced under spontaneous ventilation through a laryngeal mask airway in a patient with a fractured tracheal stent.
气管支架是在气管狭窄时维持气道通畅的一种有效方法。虽然已有关于气管狭窄患者气管内支架置入的麻醉技术报道，但气管支架患者的全身麻醉管理尚未完全确立。
我们报告了一例气管支架部分断裂患者的麻醉管理情况。一名65岁的结肠癌男性患者计划在全身麻醉下行结肠切除术。八年前，该患者因肺癌置入了气管支架。术前评估发现气管支架的一部分已穿透食管。我们通过喉罩气道自主呼吸诱导全身 - 硬膜外麻醉，以避免正压通气引起的纵隔气肿。该患者已随访2年，无任何呼吸并发症。
对于气管支架断裂的患者，可通过喉罩气道在自主通气下安全诱导全身麻醉。
