ATS
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Permission Requests
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Gómez-Caro Andrés, A.
Right arrow Articles by Martín De Nicolás, J. L.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Gómez-Caro Andrés, A.
Right arrow Articles by Martín De Nicolás, J. L.
Related Collections
Right arrow Trachea and bronchi
Right arrowRelated Article

Ann Thorac Surg 2005;79:1872-1878
© 2005 The Society of Thoracic Surgeons

Original article: General thoracic

Successful Conservative Management in Iatrogenic Tracheobronchial Injury

Abel Gómez-Caro Andrés, MDa,*, Francisco Javier Moradiellos Díez, MDa, Pilar Ausín Herrero, MDb, Vicente Díaz-Hellín Gude, MDa, Emilio Larrú Cabrero, MD, PhDa, Eduardo de Miguel Porch, MDb, José Luis Martín De Nicolás, MDa

a Department of Thoracic Surgery, Hospital Universitario 12 de Octubre, Madrid, Spain
b Department of Pneumology, Hospital Universitario 12 de Octubre, Madrid, Spain

Accepted for publication October 4, 2004.

* Address reprint requests to Dr Gómez-Caro, Department of Thoracic Surgery, Hospital Universitario 12 de Octubre, Crta. Andalucía KM 5.400, Madrid, Spain (E-mail: abelitov{at}yahoo.es).

BACKGROUND: The aim of this study was to describe and to assess the effectiveness of conservative treatment as the chosen treatment for managing iatrogenic tracheobronchial injuries (ITBI).

METHODS: Between January 1993 and December 2003, 33 tracheobronchial injuries were treated in our hospital. Eighteen (54.5%) were ITBI and 15 (45.5%) were traumatic noniatrogenic injuries. Of the ITBI patients, sex distribution was 15 (83%) females and 3 (17%) males with a mean age of 57.7 ± 20.7 years (range, 17 to 88 years). Fifteen (83.3%) of the injuries were caused by orotracheal intubation and 3 (15.7%) by tracheotomy. The average diagnostic delay was 25.7 ± 22.9 hours. The mean injury size was 2.83 ± 1.02 cm (range, 1 to 4 cm). Nine (50%) injuries were located in the cervical trachea, 6 (33.3%) in the thoracic trachea, and 3 (16%) involved both trachea and main bronchi. Conservative treatment was chosen for 17 (94.4%) of the 18 cases. We performed surgical repair in only 1 case owing to progressive subcutaneous emphysema and increasing difficulty with mechanical ventilation.

RESULTS: No complications arose from the use of conservative treatment. Four patients (22%) died in our hospital, 3 of these of non-ITBI-related causes. Mortality was not related to four variables: sex, diagnostic delay, location, or size of the ITBI. Fourteen of the 18 patients (77.7%) were discharged uneventfully, and the endoscopic and clinical follow-up examinations were satisfactory in all patients.

CONCLUSIONS: Conservative treatment for ITBI is effective regardless of production, size, or site of the injuries. Surgical treatment is advisable in specific cases: rapid progression of subcutaneous and mediastinal emphysema, mediastinitis, and difficulty with mechanical ventilation.


Related Article

Invited commentary
John Calhoon, Luis F. Angel, Daniel Martinez, and Scott B. Johnson
Ann. Thorac. Surg. 2005 79: 1878. [Extract] [Full Text] [PDF]



This article has been cited by other articles:


Home page
 J. Thorac. Cardiovasc. Surg.Home page
C. E. Denlinger, N. Veeramachaneni, A. S. Krupnick, G. A. Patterson, and D. Kreisel
Nonoperative management of large tracheal injuries
J. Thorac. Cardiovasc. Surg., September 1, 2008; 136(3): 782 - 783.
[Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
A. Wurtz, L. Benhamed, M. Conti, and H. Porte
Management of postintubation tracheal ruptures
J. Thorac. Cardiovasc. Surg., July 1, 2008; 136(1): 231 - 232.
[Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
M. Conti, L. Benhamed, H. Porte, and A. Wurtz
Iatrogenic tracheobronchial injury: a support to nonsurgical management.
Ann. Thorac. Surg., May 1, 2008; 85(5): 1843 - 1844.
[Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
M. Conti, H. Porte, and A. Wurtz
Conservative management of postintubation tracheobronchial ruptures
J. Thorac. Cardiovasc. Surg., September 1, 2007; 134(3): 821 - 822.
[Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
T. Schneider, K. Storz, H. Dienemann, and H. Hoffmann
Management of Iatrogenic Tracheobronchial Injuries: A Retrospective Analysis of 29 Cases
Ann. Thorac. Surg., June 1, 2007; 83(6): 1960 - 1964.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
E. Mercadante, C. Giovannini, and M. Carlini
Reply.
Ann. Thorac. Surg., May 1, 2007; 83(5): 1925 - 1925.
[Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
M. Conti, E. Robin, H. Porte, C.-H. Marquette, and A. Wurtz
Management of Postintubation Tracheobronchial Ruptures
Ann. Thorac. Surg., May 1, 2007; 83(5): 1924 - 1924.
[Full Text] [PDF]

Home page
 ChestHome page
M. Conti, M. Pougeoise, A. Wurtz, H. Porte, F. Fourrier, P. Ramon, and C.-H. Marquette
Management of postintubation tracheobronchial ruptures.
Chest, August 1, 2006; 130(2): 412 - 418.
[Abstract] [Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
ANN THORAC SURG ASIAN CARDIOVASC THORAC ANN EUR J CARDIOTHORAC SURG
J THORAC CARDIOVASC SURG ICVTS ALL CTSNet JOURNALS
Copyright © 2005 by The Society of Thoracic Surgeons.