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Year : 2020  |  Volume : 3  |  Issue : 1  |  Page : 45-48

An alternative method for tracheal stent deployment in malignant tracheo-oesophageal fistula

1 Department of Onco-Anaesthesia and Palliative Medicine, Dr BRAIRCH, All India Institute of Medical Sciences, New Delhi, India
2 Department of Pulmonary Medicine and Sleep Disorders, All India Institute of Medical Sciences, New Delhi, India

Correspondence Address:
Dr. Rakesh Garg
Room No. 139, First Floor, Department of Onco.Anaesthesia and Palliative Medicine, Dr. BRAIRCH, All India Institute of Medical Sciences, Ansari Nagar, New Delhi - 110 029
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ARWY.ARWY_4_20

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Malignant tracheo-oesophageal fistula, a troublesome complication of oesophageal cancer, often requires placement of airway self-expanding metallic stent (SEMS) for palliation. Devices such as SEMS can be deployed by flexible or rigid bronchoscopy under sedation or general anaesthesia. General anaesthesia is preferred as it not only provides better operating conditions to the pulmonologist but also avoids unnecessary patient movement and coughing during stent deployment which could result in stent displacement. However, general anaesthesia can be complicated by the presence of comorbidities, poor general condition and deranged blood gases. A comprehensive perioperative anaesthetic plan with a team approach can reduce complications. Stent deployment can be difficult in a few cases using conventional techniques such as with a rigid bronchoscope. We describe the anaesthetic management of tracheobronchial stent placement by flexible bronchoscopy which is one of the alternate techniques of stent placement.

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