Anaesthetic management of endotracheal stent placement: A case series highlighting challenges in shared airway procedures

Malignant airway compromise secondary to oesophageal carcinoma poses significant anaesthetic challenges, particularly when endotracheal stent placement is required. This case series presents two patients with advanced squamous cell carcinoma of the oesophagus with tracheal involvement requiring rigid bronchoscopy and endotracheal stent placement. The first case involved a 48-year-old female with tracheoesophageal fistula, while the second was a 69-year-old male with endobronchial stent placement complicated by device dislodgement. Both cases were managed with total intravenous anaesthesia (TIVA) using propofol, variable muscle relaxant strategies, and manual ventilation via the rigid bronchoscope. Key challenges included shared airway management without secure ventilation, difficulty confirming adequate ventilation, risk of airway trauma, and patient debilitation. Both procedures were completed successfully with maintained oxygenation and uneventful postoperative recovery. This series illustrates the importance of meticulous preoperative planning, adequate anaesthetic depth, and careful intraoperative management in complex shared airway procedures.