Iatrogenic ruptures of the tracheobronchial tree1

Hofmann, Hans‐Stefan; Rettig, G; Radke, J.; Neef, H; Silber, RE

doi:10.1016/s1010-7940(02)00037-4

Cited by 160 publications

(141 citation statements)

References 14 publications

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“…That is not surprising as female patients are known to be prone to post-intubation injuries more frequently than males [2,3,5,13,29,30] and iatrogenous disruptions are most likely to benefit from conservative treatment than traumatic ones, as reported by us (table 5) and by most previous studies [10][11][12][13][14][15][16][17].…”

Section: Discussionsupporting

confidence: 55%

“…Mortality rates as high as 60% are reported after surgical treatment of tracheal disruptions [2,5,30,31]. Co-morbidities and/or underlying severe clinical conditions may significantly affect the overall mortality rate after surgery.…”

Section: Discussionmentioning

confidence: 99%

“…Tracheal disruptions are usually considered as life threatening conditions, responsible for potentially fatal, acute or late complications if not approached early by surgery [1][2][3][4][5][6][7][8]. Nonetheless, the optimal management of such injuries is still controversial [9].…”

Section: Introductionmentioning

confidence: 99%

“…Accordingly, only small, non full-thickness iatrogenic injuries are usually deemed suitable for conservative management [1][2][3][4][5][6][7][8][9]. Nonetheless, a few cases and a few recent series have been reported with even wide full-thickness iatrogenic tracheal lacerations successfully managed by means of conservative treatment [10][11][12][13][14][15][16][17].…”

Section: Introductionmentioning

confidence: 99%

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Treatment of iatrogenic and traumatic tracheal disruptions

Leoncini¹,

Iurilli²,

Boni³

et al. 2016

Monaldi Arch Chest Dis

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Background and aim. The optimal management of tracheal disruptions is still controversial. It is usually postulated that lesions wider than 1 or 2 centimetres and/or lesions of full-thickness should be treated by surgery at an early stage. Such a statement is not supported by any proven evidence. On the contrary, the conservative management of such injuries has also produced very good results according to recent reports. The aim of this study is to investigate whether conservative treatment can be safely used for wide tracheal lacerations and to assess any possible association between clinical features and modality of treatment. Methods. Records of all patients with iatrogenic and traumatic tracheal disruptions observed between January 1992 and December 2006 were collected and retrospectively reviewed. Data regarding mechanism of injury, clinical and morphological features and modalities of treatment were registered. All possible associations between clinical features and modalities of treatment were investigated. Results. 23 patients were observed overall. There were 6 males and 17 females with a median age of 58 years (range 20-84 yrs). 15 patients had undergone single tube intubation. One patient had his trachea injured during an esophagectomy. Ruptures were secondary to blunt (n=5) and open (n=2) trauma in 7 patients. Lesions varied in length between 1 and 7 centimetres (median length 3 centimetres) and all were full-thickness. The time interval until diagnosis varied between 0 and 72 hours (median 6 hours). Respiratory failure was evident in 7 patients. 16 patients (69.5%) with lacerations ranging in length between 1 and 5.5 centimetres (median length 2.75 cm) underwent conservative treatment. Seven patients (30.5%) underwent surgery. The follow up was completed for 16 patients and varied between 15 and 105 months (median 22.5). One patient died after surgical treatment. No mortality or late major sequelae were registered after conservative treatment. Female sex, absence of respiratory failure and delayed diagnosis was associated with the conservative treatment. Conclusions. Conservative treatment can play a major role even in cases of wide tracheal lacerations. Clinical rather than morphological features should be regarded as main criteria for treatment. The conservative treatment is particularly indicated in the case of stable respiratory parameters independent of the size and the depth of the lesion.

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Section: Discussionsupporting

confidence: 55%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Treatment of iatrogenic and traumatic tracheal disruptions

Leoncini¹,

Iurilli²,

Boni³

et al. 2016

Monaldi Arch Chest Dis

View full text Add to dashboard Cite

show abstract

“…Iatrogenic tracheal injury is a rare (less than 0.01%) [3] complication of endotracheal intubation. Prolonged endotracheal intubation [7] can cause pressure necrosis or erosion of the lower cervical trachea.…”

Section: Discussionmentioning

confidence: 99%