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Ann Thorac Surg 2008;85:1844. doi:10.1016/j.athoracsur.2007.12.058
© 2008 The Society of Thoracic Surgeons
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Correspondence

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Hans Hoffmann, MD, PhD, Thomas Schneider, MD, Konstantina Storz, MD, Hendrik Dienemann, MD, PhD

Department of Thoracic Surgery, Thoraxklinik am Universitätsklinikum Heidelberg, Amalienstrasse 5, Heidelberg D-69126, Germany

(Email: hans.hoffmann{at}urz.uni-heidelberg.de).

To the Editor:

We appreciate the comments by Conti and colleagues [1] on our article [2]. We generally agree with their approach to the management of iatrogenic tracheobronchial injuries and their comments are consistent with our statements in the article. With growing experience and favorable results after conservative therapy of tracheal injuries, our rate of surgical therapy declined. This retrospective review [2] also represents our learning curve in the management of tracheal injuries. The extent of the mediastinal emphysema was an important criterion for indication toward surgery in the earlier cases, whereas the instability of ventilation management was the main criterion in the later cases. Pneumothorax per se may not be an indication for surgery if the patient can be sufficiently ventilated. Whenever possible we opt for nonoperative therapy, and the criteria for conservative treatment are redeemed.


   References
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  1. Conti M, Benhamed L, Porte H, Wurtz A. Iatrogenic tracheobronchial injury: a support to nonsurgical management(letter) Ann Thorac Surg 2008;85:1843-1844.[Free Full Text]
  2. Schneider T, Storz K, Dienemann H, Hoffmann H. Mangement of iatrogenic tracheobronchial injuries: a retrospective analysis of 29 cases Ann Thorac Surg 2007;83:1960-1964.[Abstract/Free Full Text]




This Article
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Right arrow Articles by Dienemann, H.

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