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首页> 外文期刊>Surgical Endoscopy >A modified laryngeal mask in the endoscopic management of an esophageal tumor.
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A modified laryngeal mask in the endoscopic management of an esophageal tumor.

机译：改良的喉罩在食管肿瘤内窥镜处理中的应用。

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摘要

The laryngeal mask airway (LMA) can be used for gastroscopy, but its use can result in loss of the seal and/or displacement of the cuff. We describe an LMA that was specifically modified for gastroscopy and report its use in a patient with an esophageal tumor. The modified LMA has (a) a second tube that allows instruments to be directed toward the esophagus and (b) a second cuff mounted on the dorsal surface that increases the efficacy of the seal with the larynx. A 78-year-old man weighing 65 kg presented with a large mediastinal adenocarcinoma that was infiltrating the lateral wall of the thoracic esophagus. An esophagoscopy under anesthesia was planned to debulk the tumor. The modified LMA was inserted easily following induction with propofol. Anesthesia was maintained with propofol and 50% O2 in air and spontaneous ventilation. A lubricated 10.5-mm external diameter gastroscope was inserted into the second tube and passed easily into the esophagus. The tumor was successfully debulked using a polypectomy snare and an argon plasma coagulator. There was no loss of seal or displacement of the cuff, and the patient was stable throughout the procedure. We conclude that gastroscopy is feasible with the modified LMA. The device has a potential application in patients who require ventilatory support during gastroscopy.
机译：喉罩气道（LMA）可用于胃镜检查，但其使用会导致密封性丧失和/或袖带移位。我们描述了一种专门针对胃镜修改的LMA，并报告了其在食道肿瘤患者中的使用。改进的LMA具有（a）允许器械对准食道的第二根管和（b）安装在背侧表面的第二个袖带，可提高与喉部的密封效果。一名重65公斤的78岁男子出现了一个巨大的纵隔腺癌，该癌正在浸入胸腔食道的侧壁。计划在麻醉下进行食管镜检查以消散肿瘤。丙泊酚诱导后可轻松插入修饰的LMA。在空气中和自发通气的情况下，使用异丙酚和50％O2维持麻醉。将润滑的外径为10.5毫米的胃镜插入第二管，并轻松通过食道。使用息肉切除圈套器和氩气血浆凝结器成功地将肿瘤消散。没有丧失密封性或袖带移位，并且患者在整个过程中保持稳定。我们得出结论，胃镜检查是可行的与修改的LMA。该设备在胃镜检查期间需要通气支持的患者中具有潜在的应用。

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