Iatrogenic injuries to the trachea and main bronchi

Tomasz Gil; Janusz Warmus; Janusz Włodarczyk; Zbigniew Grochowski; Krzysztof Bederski; Piotr Kocoń; Piotr Talar; Jarosław Kużdżał

doi:10.5114/kitp.2016.61043

eISSN: 1897-4252
ISSN: 1731-5530

Kardiochirurgia i Torakochirurgia Polska/Polish Journal of Thoracic and Cardiovascular Surgery

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2/2016
vol. 13

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abstract:

Iatrogenic injuries to the trachea and main bronchi

Tomasz Gil

,

Janusz Warmus

,

Janusz Włodarczyk

,

Zbigniew Grochowski

,

Krzysztof Bederski

,

Piotr Kocoń

,

Piotr Talar

,

Jarosław Kużdżał

Kardiochirurgia i Torakochirurgia Polska 2016; 13 (2): 113-116

DOI: https://doi.org/10.5114/kitp.2016.61043

Online publish date: 2016/07/03

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Introduction: Iatrogenic tracheobronchial injuries are rare.

Aim: To analyse the mechanism of injury, symptoms and treatment of these patients.

Material and methods: Retrospective analysis of hospital records of all patients treated for main airway injuries between 1990 and 2012 was performed.

Results: There were 24 patients, including 21 women and 3 men.Mean time between injury and initiation of treatment was 12 hours (range: 2-48). In 16 patients the injury occurred during tracheal intubation, in 1 during rigid bronchoscopy, in 1 during rigid oesophagoscopy, in 1 during mediastinoscopy and in 5 during open surgery. Mean length of airway tear was 3.8 cm (range: 1.5-8). In 1 patient there was an injury to the cervical trachea and in the remaining 23 in the thoracic part of the airway. The treatment included repair of the membranous part of the trachea performed via right thoracotomy in 10 patients (in 1 patient additionally coverage with a pedicled intercostal muscle flap was used), a self-expanding metallic stent in 1 patient, suture of the right main bronchus and the oesophagus in 1, left upper sleeve lobectomy in 1, right upper lobectomy in 1, implantation of a silicone Y stent in 3, mini-tracheostomy in 1, and conservative treatment in 5 patients.

Conclusions: Intubation is the most frequent cause of iatrogenic main airway injuries. Patients with these life-threatening complications require an individualised approach and treatment in a reference centre.

keywords:

Iatrogenic injuries to the trachea and main bronchi

Tomasz Gil , Janusz Warmus , Janusz Włodarczyk , Zbigniew Grochowski , Krzysztof Bederski , Piotr Kocoń , Piotr Talar , Jarosław Kużdżał

trachea, airway, iatrogenic injury

Tomasz Gil

,

Janusz Warmus

,

Janusz Włodarczyk

,

Zbigniew Grochowski

,

Krzysztof Bederski

,

Piotr Kocoń

,

Piotr Talar

,

Jarosław Kużdżał