Онкология ANAESTHESIA AND RESPIRATORY SUPPORT WHEN TRACHEOBRONCHIAL STENTING IN PATIENTS WITH DISEASE TRACHEA OF VARIOUS ETIOLOGY
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ANAESTHESIA AND RESPIRATORY SUPPORT WHEN TRACHEOBRONCHIAL STENTING IN PATIENTS WITH DISEASE TRACHEA OF VARIOUS ETIOLOGY

A.F. Khasanov, V.R. Trifonov, V.Yu. Murav’yov, E.I. Sigal, N.A. Khasanova,
N.A. Baisheva, A.I. Ivanov

Tatarstan Regional Clinical Cancer Center, Kazan
Volga Region branch of RCRC named after N.N. Blokhin RAMS, Kazan

 

Abstract. Endoscopic stenting of the trachea and bronchi may be rapid therapeutic eff ect or to postpone the surgery to compensate for respiratory failure in patients with cicatricial stenosis, and in cancer patients, are not subject to surgery, can signifi cantly improve the quality of life, create the possibility of palliative care and improve survival.

Material and methods: A retrospective was investigated 23 (8 women, 15 men) patients who underwent 28 procedures associated with recanalization and stenting for benign tracheal [9] and malignant [14] diseases under anesthesia. The choice is intravenous anesthesia with muscle relaxation and high-lung ventilation with tracheal stenting was determined dire state of patients, extent and location of stenosis, reference endoscopists using a laryngoscope and a lack of tightness of the airways.

Results: After stenting in 78.3% (18/23) of cases patients noted signifi cant improvement of health, reduction of dyspnea on exertion, even in 8.7% (2/23) of cases — only a slight improvement, 4.35% (1/23) of cases the patient did not improve and noted in 8.7% (2/23) of cases worsened condition (death). Complications after stent placement occurred in 10 (43.5%) of 23 patients. Stent migration occurred in four (17.4%) patients, purulent tracheobronchitis occurred in two (8.7%) patients, paroxysmal cough with pain in the postoperative period occurred in one (4.35%) patients. One (4.35%) patient coughed stent during paroxysmal cough, against swelling of the vocal cords and subglottic. Two of them (8.7%) patients in the stenting procedure was not successful, and they died due to progression of the primary cancer and severe respiratory failure.

Conclusions: Anesthesia protection of patients and is an important component of endoscopic stenting respiratory self-expanding stents, has a number of features associated with severe general condition of patients and the need for mechanical ventilation in the absence of integrity of the airways. High anesthetic risk being justifi ed by the signifi cant improvement of patients, decreased dyspnea on exertion, even the vast majority of patients.

Key words: airway obstruction, stenting of the trachea, anesthesia, high-frequency ventilation.





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