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Conservative treatment for postintubation tracheobronchial rupture
J Jougon1, M Ballester, E Choukroun
1Thoracic Surgery Unit, Centre Médico-Chirurgical, Haut Lévèque Hospital, Pessac, France. jacques.jougon@chu-aquitaine.fr
Background:
Postintubation tracheobronchial rupture is usually responsible for unstable intraoperative or postoperative conditions, and its management is discussed. We insist on conservative treatment as a viable alternative after late diagnosis of postintubation tracheobronchial rupture.
Methods:
We conducted a retrospective study including 14 consecutive patients treated between April 1981 and July 1998.
Results:
Twelve tracheobronchial ruptures occurred after intubation for general surgery and two after thoracic surgery. In all cases, the tear consisted of a linear laceration of the posterior membranous wall of the tracheobronchial tree ranging from 2 to 6 cm. One death occurred in a very weak patient unfit to undergo a redo operation for surgical repair. Seven patients were treated conservatively and cured without sequelae. Six patients underwent surgical repair, of whom 2 were diagnosed and repaired intraoperatively.
Conclusions:
Aggressive surgical repair is not always mandatory after delayed diagnosis of iatrogenic tracheobronchial rupture. Conservative treatment must often be considered, except after lung resection.