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. 2016 Dec 20;22(6):348-353.
doi: 10.5761/atcs.oa.16-00189. Epub 2016 Nov 14.

Does Surgical Repair Still have a Role for Iatrogenic Tracheobronchial Rupture? Clinical Analysis of a Thoracic Surgeon's Opinion

Sung Kwang Lee  1 , Do Hyung Kim, Sang Kwon Lee, Yeong-Dae Kim, Jeong Su Cho, Hoseok I
Affiliations

Does Surgical Repair Still have a Role for Iatrogenic Tracheobronchial Rupture? Clinical Analysis of a Thoracic Surgeon's Opinion

Sung Kwang Lee et al. Ann Thorac Cardiovasc Surg. .

Abstract

Purpose: The choice of surgical repair or conservative treatment for iatrogenic tracheobronchial rupture (ITBR) remains controversial. However, thoracic surgeons consider that surgical repair is an important treatment modality. The purpose of this study was to evaluate the clinical results from the perspective of the surgery-preferred group.

Methods: We treated 11 patients (8 women and 3 men; age: 52.6 ± 22.9 years) with ITBR from January 2011 to January 2016. A posterolateral thoracotomy or a trans-tracheal approach was performed according to the mechanism of injury.

Results: Nine patients underwent surgery, and all patients received primary repair. Five patients received a right posterolateral thoracotomy, whereas one patient received a left posterolateral thoracotomy. No mortality or morbidity related to the surgery was observed. The mechanical ventilation time was 65.9 ± 99.2 hours. The intensive care unit duration was 19.7 ± 33.3 days. Two patients received conservative treatment, and all patients died of another disease that was not related to the conservative treatment.

Conclusion: Our mortality or morbidity due to surgery was not higher than world literature results of conservative treatment. We thought surgery is the primary treatment choice for ITBR in the absence of a good indication for conservative treatment.

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Figures

Fig. 1
Fig. 1. A right lateral thoracotomy was performed through the fifth intercostal space if iatrogenic tracheobronchial rupture developed due to intubation. (a) After removing the mediastinal pleura, the area between the esophagus and posterior trachea was dissected, and the esophagus was retracted using a silicone drain to expose the tear site. Interrupted primary sutures were used to repair the tear (b). If ITBR developed due to a tracheostomy, the tracheostomy skin incision was laterally extended about 1 cm (c). A full tracheal incision was made lateral to the transverse midline incision in the anterior wall of the trachea. Running absorbable sutures were used to repair the area proximal and distal to the laceration in the posterior wall through the full tracheotomy site (d). ITBR: iatrogenic tracheobronchial rupture
See this image and copyright information in PMC

References

    1. Jougon J, Ballester M, Choukroun E, et al. Conservative treatment for postintubation tracheobronchial rupture. Ann Thorac Surg 2000; 69: 216-20. - PubMed
    1. Beiderlinden M, Adamzik M, Peters J. Conservative treatment of tracheal injuries. Anesth Analg 2005; 100: 210-4. - PubMed
    1. Gomez-Caro Andres A, Moradiellos Diez FJ, Ausin Herrero P, et al. Successful conservative management in iatrogenic tracheobronchial injury. Ann Thorac Surg 2005; 79: 1872-8. - PubMed
    1. Conti M, Pougeoise M, Wurtz A, et al. Management of postintubation tracheobronchial ruptures. Chest 2006; 130: 412-8. - PubMed
    1. Leoncinii G, Iurilli L, Boni L, et al. Treatment of iatrogenic and traumatic tracheal disruptions. Monaldi Arch Chest Dis 2008; 69: 119-27. - PubMed

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