Iatrogenic Tracheal Ruptures: Review of the Literature and Personal Experience on 11 Cases - Open Journal of Thoracic Surgery

OJTS > Vol.3 No.4, December 2013

Iatrogenic Tracheal Ruptures: Review of the Literature and Personal Experience on 11 Cases ()

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DOI: 10.4236/ojts.2013.34027 4,437 Downloads 6,608 Views Citations

Author(s)

Bülent Aydemir, Sezai Çelik, Oya Uncu, Handan Tanrıkulu, Tamer Okay

Affiliation(s)

Department of Thoracic Surgery, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Center, Istanbul, Turkey.
Department of Thoracic Surgery, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Center, Istanbul, Turkey;.
Department of Thoracic Surgery, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey..

ABSTRACT

Objective: Iatrogenic tracheal rupture is a rare, but life-threatening complication of orotracheal intubation. In this retrospective study, etiology, and diagnostic and therapeutic approaches for iatrogenic tracheal ruptures were reviewed. Method: Eleven patients (6 males and 5 females) were diagnosed and treated for iatrogenic tracheal rupture in our clinic. The laceration occurred after orotracheal intubation in 7 cases, and during percutaneous tracheostomy and emergency tracheostomy in the other four cases, respectively. Diagnosis was made during thoracic surgery in 5 cases. The remaining cases were diagnosed in the post-operative period; the most common symptoms were mediastinal and subcutenous emphysema and pneumothorax. Results: The diagnosis was confirmed by bronchoscopy in all cases. The lacerations were longitudinal, 1-7 cm in length and were located in the distal membranous trachea. While ruptures detected intraoperatively were repaired during the surgery, the others were treated conservatively. No mortality was observed among cases treated surgically. However, three of the cases treated conservatively died (50%), and the cause of death was the underlying disease requiring intubation. Conclusion: We are in the opinion that primary disease is a determinant of patient outcome. Except cases identified during surgery, emergency surgical interventions should be preferred in patients, in whom ventilation cannot be achieved. On the other hand, bronchoscopic fibrin glue instillation should additively be applied to conservative treatment of tracheal lacerations.

KEYWORDS

Tracheal Rupture; Iatrogenic; Surgery; Conservative Treatment

Share and Cite:

B. Aydemir, S. Çelik, O. Uncu, H. Tanrıkulu and T. Okay, "Iatrogenic Tracheal Ruptures: Review of the Literature and Personal Experience on 11 Cases," Open Journal of Thoracic Surgery, Vol. 3 No. 4, 2013, pp. 130-134. doi: 10.4236/ojts.2013.34027.

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