HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Edoardo Mercadante Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Mercadante, E. Articles by Carlini, M. Search for Related Content PubMed Articles by Mercadante, E. Articles by Carlini, M. Related Collections Related Article

Ann Thorac Surg 2007;83:1925
© 2007 The Society of Thoracic Surgeons

---

Correspondence

Reply

Department of General Thoracic and Abdominal Surgery, S. Eugenio Hospital, Piazzale dell’Umanesimo 10, Rome, 00144 Italy

(Email: e.mercadante{at}tiscali.it).

To the Editor:

We thank Dr Conti and colleagues [1] for their supportive comments on our article regarding conservative treatment of a major tracheal iatrogenic injury after left pneumonectomy [2]. We congratulate his group on their recent, exhaustive article regarding management of post-intubation tracheobronchial ruptures [3]. This article was not available when we wrote our case report.

Management of this life-threatening complication is still not unanimously clarified and some authors [4, 5] have proposed criteria for nonsurgical treatment. They consider the size of the tear as one of the most important criteria for the decision process. We disagree with this statement, and our experience shows that nonoperative management is successful also for major ruptures. However, we also think that management should be tailored to the patient, and we certainly accept the comments and criticism of Conti and colleagues [1] regarding our conclusion. Our article is a single case report and we think that larger experience is needed to change the classical attitude. As Conti and colleagues’ [1] experience with 30 patients is quite similar to ours and supports conservative treatment as the best approach for iatrogenic tracheobronchial ruptures, we now consider surgical repair as a viable option only for highly selected cases.

	References

Top References

 

1. Conti M, Robin E, Porte H, Marquette C-H, Wurtz A. Management of postintubation tracheobronchial ruptures(letter) Ann Thorac Surg 2007;83:1924.[Free Full Text]
2. Mercadante E, Giovannini C, Castaldi F, et al. Major tracheal injury during pneumonectomy: conservative treatment Ann Thorac Surg 2006;81:2285-2287.[Abstract/Free Full Text]
3. Conti M, Poungeoise M, Wurtz A, et al. Management of postintubation tracheobronchial ruptures Chest 2006;130:412-418.[Medline]
4. Jougon J, Ballester M, Choukroun E, et al. Conservative treatment for postintubation tracheobronchial rupture Ann Thorac Surg 2000;69:216-220.[Abstract/Free Full Text]
5. Gomez-Caro Andrez A, Moradiellos Diez FJ, Ausin Herrero P, et al. Successful conservative management in iatrogenic tracheo-bronchial injury Ann Thorac Surg 2005;79:1872-1878.[Abstract/Free Full Text]

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Edoardo Mercadante Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Mercadante, E. Articles by Carlini, M. Search for Related Content PubMed Articles by Mercadante, E. Articles by Carlini, M. Related Collections Related Article