Original articleGeneral thoracicManagement of Iatrogenic Tracheobronchial Injuries: A Retrospective Analysis of 29 Cases
Section snippets
Patients and Methods
From July 1996 to June 2006, 29 patients with iatrogenic tracheobronchial injuries were diagnosed at our institution, and their records were analyzed for patient profile, cause, and extent of tracheobronchial injury, clinical symptoms, chosen treatment option, treatment success or failure, and patient outcome. There were 20 women (69%) and 9 men (31%), with a mean age of 65 years (range, 17 to 89 years). The ethics committee of the University of Heidelberg approved this retrospective study
Treatment Success and Failure
Eleven patients underwent conservative management. These patients presented with the following symptoms: cutaneous emphysema in 2, mediastinal emphysema in 6, pneumothorax in 1, and no symptoms in 4 (Table 3). In all cases, the lacerations were either superficial or sufficiently covered by the esophagus. Two of these lacerations occurred at our institution: one happened when a tracheal canula was changed through a tracheostoma and the other was associated with the bronchoscopic dilation of a
Comment
Tracheobronchial injuries are rare but potentially life-threatening complications of endotracheal intubations or endobronchial interventions. Our data in essence reconfirm the reported experiences of other authors, that the cause of the iatrogenic injury in most cases was single lumen intubation under emergency conditions or dilational tracheostomies [2, 13, 15]. The risk for tracheal lacerations seems to increase with difficult or emergency intubations, multiple vigorous attempts of an
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