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. 1993 May;75(3):189–192.

An improved method for oesophageal intubation.

S R Bramhall 1, P S Veitch 1, D Gourevitch 1, A C Wicks 1
PMCID: PMC2497890  PMID: 7686732

Abstract

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.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Atkinson M., Ferguson R., Ogilvie A. L. Management of malignant dysphagia by intubation at endoscopy. J R Soc Med. 1979 Dec;72(12):894–897. doi: 10.1177/014107687907201206. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Atkinson M., Ferguson R., Parker G. C. Tube introducer and modified Celestin tube for use in palliative intubation of oesophagogastric neoplasms at fibreoptic endoscopy. Gut. 1978 Jul;19(7):669–671. doi: 10.1136/gut.19.7.669. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Branicki F. J., Ogilvie A. L., Willis M. R., Atkinson M. Structural deterioration of prosthetic oesophageal tubes: an in vitro comparison of latex rubber and silicone rubber tubes. Br J Surg. 1981 Dec;68(12):861–864. doi: 10.1002/bjs.1800681210. [DOI] [PubMed] [Google Scholar]
  4. Hagenmüller F., Sander C., Sander R., Ries G., Classen M. Laser and endoluminal 192-iridium radiation. Endoscopy. 1987 Nov;19 (Suppl 1):16–18. doi: 10.1055/s-2007-1018302. [DOI] [PubMed] [Google Scholar]
  5. Hagenmüller F., Sander C., Sander R., Ries G., Classen M. Palliation of obstructive oesophageal and cardial carcinomas with laser and endoluminal iridium radiation. Baillieres Clin Gastroenterol. 1987 Oct;1(4):917–922. doi: 10.1016/0950-3528(87)90027-3. [DOI] [PubMed] [Google Scholar]
  6. Kratz J. M., Reed C. E., Crawford F. A., Stroud M. R., Parker E. F. A comparison of endoesophageal tubes. Improved results with the Atkinson tube. J Thorac Cardiovasc Surg. 1989 Jan;97(1):19–23. [PubMed] [Google Scholar]
  7. Lishman A. H., Dellipiani A. W., Devlin H. B. The insertion of oesophagogastric tubes in malignant oesophageal strictures: endoscopy or surgery? Br J Surg. 1980 Apr;67(4):257–259. doi: 10.1002/bjs.1800670409. [DOI] [PubMed] [Google Scholar]
  8. Ogilvie A. L., Dronfield M. W., Ferguson R., Atkinson M. Palliative intubation of oesophagogastric neoplasms at fibreoptic endoscopy. Gut. 1982 Dec;23(12):1060–1067. doi: 10.1136/gut.23.12.1060. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Pass H. I., Reed C. E. Lasers in the management of upper aerodigestive malignancies. Important Adv Oncol. 1990:159–179. [PubMed] [Google Scholar]
  10. Richter J. M., Hilgenberg A. D., Christensen M. R., Logan D., Mathisen D. J., Schapiro R. H., Kelsey P. B., Grillo H. C. Endoscopic palliation of obstructive esophagogastric malignancy. Gastrointest Endosc. 1988 Nov-Dec;34(6):454–458. doi: 10.1016/s0016-5107(88)71433-9. [DOI] [PubMed] [Google Scholar]
  11. Rose J. D., Smith P. M. Fibre endoscopic insertion of palliative oesophageal tubes with the Nottingham introducer. J R Soc Med. 1983 Apr;76(4):266–268. doi: 10.1177/014107688307600406. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Souttar H. S. A METHOD OF INTUBATING THE OESOPHAGUS FOR MALIGNANT STRICTURE. Br Med J. 1924 May 3;1(3305):782–783. doi: 10.1136/bmj.1.3305.782. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Tytgat G. N., den Hartog Jager F. C., Haverkamp H. J. Positioning of a plastic prosthesis under fiberendoscopic control in the palliative treatment of cardio-esophageal cancer. Endoscopy. 1976 Nov;8(4):180–185. doi: 10.1055/s-0028-1098407. [DOI] [PubMed] [Google Scholar]
  14. Unruh H. W., Pagliero K. M. Pulsion intubation versus traction intubation for obstructing carcinomas of the esophagus. Ann Thorac Surg. 1985 Oct;40(4):337–342. doi: 10.1016/s0003-4975(10)60063-x. [DOI] [PubMed] [Google Scholar]

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