Transtracheal single-point stent fixation in posttracheotomy tracheomalacia under cone-beam computer tomography guidance by transmural suturing with the Berci needle - a perspective on a new tool to avoid stent migration of Dumon stents.

摘要: Tracheomalacia or tracheobronchomalacia (TM TBM) is a common problem especially for elderly patients often unfit surgical techniques. Several minimally invasive techniques have already been described. Stenting one option but in general long-time stenting accompanied by high complication rate. Stent removal more difficult case of self-expandable nitinol stents metallic comparison to silicone stents. The main disadvantage uncovered migration and plugging. We compared the operation time particular duration sufficient Dumon stent fixation with different patient severe posttracheotomy TM strongly reduced mobility vocal cords due Parkinson’s disease. combined approach simultaneous endoluminal transtracheal externalized suture under cone-beam computer tomography guidance Berci needle was far fastest (not performed) intervention, even purely suturing through rigid bronchoscope. between 5 minutes 9 needle; pure needed 51 minutes. alternative tracheobronchoplasty refused patient. In general, 180 this calculated. costs approaches are supposed vary widely fact that Germany 1 minute an room on average approximately 50–60€ inclusive taxes. our own hospital (tertiary level), it nearly 30€ per approach. Calculating additional 15 preparation transfer wake-up room, therefore total inside investigation 30 minutes, cost flexible bronchoscopy less than 6€. Although requires set-up expensive anesthesiology accompaniment, which takes longer estimated at hour still without calculation materials specialized staff would consume least 3,000€ performed needle. This difference intervention calculated achieved non-surgical 60 suite.