Palliation of intrathoracic tracheal compression with a silastic tracheobronchial stent.

Content Provider	Semantic Scholar
Author	Westaby, Stephen Shepherd, M. P.
Copyright Year	1983
Abstract	Asphyxia due to extrinsic tracheal compression by nonresectable tumour in the mediastinum is a particularly distressing problem, hitherto not amenable to relief by surgical means. Tracheostomy may be inappropriate, either because the tube falls short of the area of compression or because the segment of trachea at the tracheostomy site is affected by the pathological process; and endotracheal intubation is unacceptable in a spontaneously breathing and fully conscious patient. Radiotherapy is logistically difficult in patients undergoing positive-pressure ventilation and for those who are on the verge of critical major airways obstruction, and it may initially exacerbate dyspnoea by causing oedema and swelling of the tumour and surrounding tissues. In 1082 Westabyl described a silastic tracheobronchial stent for intubation of the diseased or injured supracarinal trachea and main bronchi (fig 1). This is usually inserted via a tracheostomy and it has a tracheostomy side limb, which when occluded allows the patient to breath normally through the cords. We report the use of the stent without tracheostomy in a patient with a highly vascular thyroid tumour with intrathoracic extension, in whom conventional tracheostomy was impossible. We describe the method of insertion and discuss the therapeutic applications of this device.
File Format	PDF HTM / HTML
Alternate Webpage(s)	http://thorax.bmj.com/content/thoraxjnl/38/4/314.full.pdf
PubMed reference number	6867987v1
Volume Number	38
Issue Number	4
Journal	Thorax
Language	English
Access Restriction	Open
Subject Keyword	Accidental Falls Airway Obstruction Asphyxia Body tissue Bronchi Clinical act of insertion Compression of spinal cord Dyspnea Edema Intubation Intubation, Intratracheal Mediastinum Palliative Care Pathologic Processes Patients Positive-Pressure Respiration Stent, device Thyroid Diseases Trachea Tracheal Neoplasms Tracheobronchial structure Tracheostomy procedure
Content Type	Text
Resource Type	Article