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Ann Thorac Surg. 1996 May;61(5):1483-7.

Tracheobronchial lacerations after intubation and tracheostomy.

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  • 1Department of Thoracic Surgery, University Hospital of Strasbourg, France.

Abstract

BACKGROUND:

Although long-term complications of intubation and tracheostomy are well documented, little has been reported on acute complications of airway access techniques.

METHODS:

Fourteen patients (1 male and 13 female patients) aged 15 to 80 years presented with tracheobronchial lacerations after single-lumen intubation (n = 9), double-lumen intubation (n = 1), or tracheostomy (n = 4).

RESULTS:

A left bronchial laceration after double-lumen intubation was discovered and repaired intraoperatively. A tracheal laceration after single-lumen intubation was recognized during induction of anesthesia. The remaining 12 were diagnosed within 6 to 126 hours (median, 24 hours) after injury. All patients had mediastinal and subcutaneous emphysema. At endoscopy, 12 injuries were located in the thoracic trachea and 1 in the cervical trachea. Twelve underwent primary repair through a right thoracotomy (n = 11) or left cervicotomy (n = 1), and 1 was treated conservatively. Two patients with tracheostomy injury died postoperatively. All repairs healed well but one. The latter was performed 5 days after the injury; a dehiscence occurred, but healed spontaneously.

CONCLUSIONS:

We conclude that prognosis of tracheal lacerations depends both on the general health of the patient and on the rapidity of diagnosis and treatment.

Comment in

PMID:
8633963
[PubMed - indexed for MEDLINE]
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