AN IMPROVED METHOD FOR ESOPHAGEAL INTUBATION

The authors describe a method of inserting an Atkinson tube using a fl exible upper gastrointestinal endoscope which does not require the use of X-ray screening. A retrospective review of 50 patients intubated b y this technique has been undertaken and the results presented. Of the lesions, 40% were squamous cell carcinoma and 40% adenocarcinoma, wit h 84% being situated in the lower third of the oesophagus; 94% of pati ents only required one intubation. The two major complications of the procedure are tube displacement and oesophageal leak; a tube displacem ent rate of 13% was recorded, comparable with other series. Eleven pat ients (20.8%) were found to have an oesophageal leak, but this resulte d in death in only three patients (6%). The reasons for these figures are explained. An operative mortality rate of 12% is comparable with s eries using other methods. The authors conclude that this method of in tubation is as safe as Atkinson's original method but has the advantag e that X-ray screening is not required.