Anesthetic management of a patient with esophageal penetration of a tracheal stent: a case report

BACKGROUND: Tracheal stent is a good way to maintain a patent airway in case of stenosis. Although anesthesia techniques for the placement of a stent in the trachea of patients with tracheal stenosis have been reported, the management of general anesthesia in patients with a tracheal stent is not well established. CASE PRESENTATION: We report the anesthetic management in the patient with a partly fractured tracheal stent. A 65-year-old man with colon cancer was scheduled for colectomy under general anesthesia. Eight years ago, a tracheal stent was placed because of lung cancer. Preoperative evaluation revealed that a part of the tracheal stent had penetrated the esophagus. We induced general-epidural anesthesia via spontaneous breathing through a laryngeal mask airway to avoid mediastinal emphysema caused by positive pressure ventilation. The patient has been followed up for 2 years without any respiratory complications. CONCLUSION: General anesthesia can be safely induced under spontaneous ventilation through a laryngeal mask airway in a patient with a fractured tracheal stent.