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Case Reports
. 2018 Nov 28;11(1):e226500.
doi: 10.1136/bcr-2018-226500.

Insertion of a Dumon Y-stent via a permanent tracheostoma without using a rigid bronchoscope

Kazuki Hayashi  1 , Makoto Motoishi  2 , Satoru Sawai  3 , Jun Hanaoka  1
Affiliations
Case Reports

Insertion of a Dumon Y-stent via a permanent tracheostoma without using a rigid bronchoscope

Kazuki Hayashi et al. BMJ Case Rep. .

Abstract

A 63-year-old man who had received a permanent tracheostoma after oesophageal cancer surgery developed fistulas in the left and right main bronchi and suffered repeated aspiration pneumonia. Placing an indwelling Dumon Y-stent using a rigid bronchoscope is an option to treat fistula and stenosis at the tracheal bifurcation, but in some cases, it may be difficult to use a rigid bronchoscope in patients with a permanent tracheostoma. In this study, we report placing a Dumon Y-stent in a patient with a permanent tracheostoma using a specially modified stent and forceps instead of a rigid bronchoscope.

Keywords: oesophageal cancer; palliative care; respiratory cancer.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
(A) Chest contrast CT showing free air in the subcarinal lymph nodes and at the periphery of the left and right main bronchi, and a bronchomediastinal fistula (arrow). (B) Bronchoscopy showing a fistula immediately after the right main bronchus branch and a fistula located approximately 2 cm after the left main bronchus branch (arrow).
Figure 2
Figure 2
An image of a sagittal slice of the chest CT shows that the angle between the trachea and the permanent tracheal hole (white dotted line) is relatively steep.
Figure 3
Figure 3
(A) A small hole was made in the left main bronchus part of the stent (circle). (B) Gripping the small hole with forceps to replace the rigid endoscope and to guide the stent (arrow). (C) After stabilisation by compressing the tracheal bifurcation of the stent with the forceps. A nylon thread of sufficient length is placed on the proximal side of the stent so that it can be removed in an emergency. (D) Chest radiography showing that the stent has been placed in the proper position.
See this image and copyright information in PMC

References

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