An improved method for oesophageal intubation.
The authors describe a method of inserting an Atkinson tube using a flexible upper gastrointestinal endoscope which does not require the use of X-ray screening. A retrospective review of 50 patients intubated by this technique has been undertaken and the results presented. Of the lesions, 40% were squamous cell carcinoma and 40% adenocarcinoma, with 84% being situated in the lower third of the oesophagus; 94% of patients only required one intubation. The two major complications of the procedure are tube displacement and oesophageal leak; a tube displacement rate of 13% was recorded, comparable with other series. Eleven patients (20.8%) were found to have an oesophageal leak, but this resulted in death in only three patients (6%). The reasons for these figures are explained. An operative mortality rate of 12% is comparable with series using other methods. The authors conclude that this method of intubation is as safe as Atkinson's original method but has the advantage that X-ray screening is not required.
Bramhall
S R
SR
Department of Surgery, Leicester General Hospital.
Veitch
P S
PS
Gourevitch
D
D
Wicks
A C
AC
D000368:Aged; D000369:Aged, 80 and over; D004938:Esophageal Neoplasms / Q000150:complications*; D004940:Esophageal Stenosis / Q000209:etiology / Q000628:therapy*; D004947:Esophagus; D005260:Female; D006801:Humans; D007440:Intubation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D012189:Retrospective Studies