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Allergy and Airway |

A Case of Tracheal Cancer Where We Were Able to Maintain the QOL for a Long Period of Time by Fixing a DUMON Stent to the Trachea With Sutures Endoscopically for the Airway Stenosis Right Under the Glottis

Hibiki Kanda, MD; Shinichi Iwamoto, MD; Mitsuhiro Tada, MD; Emiko Nishikawa, MD; Toru Kadowaki, PhD; Masahiro Kimura, MD; Kanako Kobayashi, MD; Toshikazu Ikeda, PhD; Shuichi Yano, PhD
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National Hospital Organization Matsue Medical Center, Matsue, Japan


Chest. 2013;144(4_MeetingAbstracts):41A. doi:10.1378/chest.1702527
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Abstract

SESSION TITLE: Bronchology Global Case Reports

SESSION TYPE: Global Case Report

PRESENTED ON: Tuesday, October 29, 2013 at 01:30 PM - 02:30 PM

INTRODUCTION: In the stent placement for the airway stenosis under the glottis, T-tube stent is generally chosen in order to prevent migration. However, the problem is that tracheotomy is required to place the T-tube stent and it decreases the QOL of the patient.

CASE PRESENTATION: It was the case of a 74-year-old man, who was seen in our clinic because of respiratory discomfort. In the bronchoscopic examination, a polyp narrowing about 80% of the lumen under the glottis was found, and he was diagnosed as squamous cell carcinoma by biopsy. Since he refused surgery, after we performed endoscopic polypectomy, we added radiation treatment(external irradiation:60Gy, intracavitary irradiation:10Gy). For the subsequent recurrence, we repeatedly performed endoscopic tumor resection, but we became no longer able to control the enlargement of the tumor, so we decided to place a stent. Though we recommended the placement of T-tube to the patient, he refused it because of the necessity of tracheotomy. Then we tried to place a DUMON stent(φ14mm, 45cm long) in the narrowed area under the glottis and fix it to the trachea with sutures. First, we inserted two needles into the stent through the body surface of the neck. We led a loop thread from the needle in the proximal side into the stent and led the other nylon thread from the needle in the distal side into the stent. We endoscopically used forceps to pull the thread into the loop and pull it with the loop out to the body surface and ligated them on the neck.

DISCUSSION: This time’s procedure is very simple and can be easily performed by anyone once they get used to it. This procedure is easier than the traditional one in which people perform a tracheotomy on the narrowed area and insert a T-tube there, and the patient burden is also much reduced.

CONCLUSIONS: The method in which people endoscopically use sutures to fix a DUMON stent to the trachea for the airway stenosis under the glottis proved very useful because it can maintain the QOL of the patient after therapy.

Reference #1: 3

DISCLOSURE: The following authors have nothing to disclose: Hibiki Kanda, Shinichi Iwamoto, Mitsuhiro Tada, Emiko Nishikawa, Toru Kadowaki, Masahiro Kimura, Kanako Kobayashi, Toshikazu Ikeda, Shuichi Yano

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