Management of major tracheobronchial injuries: A 28-year experience

被引:128
作者
Rossbach, MM [1 ]
Johnson, SB [1 ]
Gomez, MA [1 ]
Sako, EY [1 ]
Miller, OL [1 ]
Calhoon, JH [1 ]
机构
[1] Univ Texas, Hlth Sci Ctr, Dept Surg, Div Thorac Surg, San Antonio, TX 78284 USA
关键词
D O I
10.1016/S0003-4975(97)01001-1
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background. Tracheobronchial injuries are rare but potentially life threatening. Their successful diagnosis and treatment often require a high level of suspicion and surgical repairs unique to the given injury. Methods. We reviewed our experience with 32 patients with tracheobronchial injuries treated over the past 28 years. Results. Forty-one percent (13/32) of the injuries were due to blunt trauma and 59% (19/32), to penetrating trauma. Most penetrating injuries were located in the cervical trachea (74%), whereas blunt injuries were more commonly located close to the carina (62%). Fifty-nine percent of the patients required urgent measures to secure the airway. Penetrating injuries were usually diagnosed by clinical findings or at surgical exploration. The diagnosis of blunt injuries was more difficult and required a high index of suspicion and the liberal use of bronchoscopy. The majority of the injuries were repaired primarily using techniques specific to the injury, and most patients returned to their normal activity soon after discharge. Conclusions. A high level of suspicion and the liberal use of bronchoscopy are important in the diagnosis of tracheobronchial injury. A tailored surgical approach is often necessary for definitive repair. (C) 1998 by The Society of Thoracic Surgeons.
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收藏
页码:182 / 186
页数:5
相关论文
共 20 条
  • [1] TRACHEOBRONCHIAL INJURY IN BLUNT AND PENETRATING CHEST TRAUMA
    BARMADA, H
    GIBBONS, JR
    [J]. CHEST, 1994, 106 (01) : 74 - 78
  • [2] TRACHEAL AND MAIN BRONCHIAL DISRUPTIONS AFTER BLUNT CHEST TRAUMA - PRESENTATION AND MANAGEMENT
    BAUMGARTNER, F
    SHEPPARD, B
    DEVIRGILIO, C
    ESRIG, B
    HARRIER, D
    NELSON, RJ
    ROBERTSON, JM
    [J]. ANNALS OF THORACIC SURGERY, 1990, 50 (04) : 569 - 574
  • [3] EARLY DIAGNOSIS OF TRAUMATIC RUPTURE OF BRONCHUS
    BURKE, JF
    [J]. JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1962, 181 (08): : 682 - &
  • [4] Ecker R R, 1971, Ann Thorac Surg, V11, P289
  • [5] EDWARDS WH, 1987, AM SURGEON, V53, P192
  • [6] ACUTE TRACHEO-BRONCHIAL INJURY
    FLYNN, AE
    THOMAS, AN
    SCHECTER, WP
    [J]. JOURNAL OF TRAUMA-INJURY INFECTION AND CRITICAL CARE, 1989, 29 (10) : 1326 - 1330
  • [7] DIAGNOSIS AND MANAGEMENT OF MAJOR TRACHEOBRONCHIAL INJURIES
    GROVER, FL
    ELLESTAD, C
    AROM, KV
    ROOT, HD
    CRUZ, AB
    TRINKLE, JK
    [J]. ANNALS OF THORACIC SURGERY, 1979, 28 (04) : 384 - 391
  • [8] TRACHEOBRONCHIAL INJURIES IN CHILDREN
    HANCOCK, BJ
    WISEMAN, NE
    [J]. JOURNAL OF PEDIATRIC SURGERY, 1991, 26 (11) : 1316 - 1319
  • [9] INJURIES OF THE TRACHEA AND MAJOR BRONCHI
    HOOD, RM
    SLOAN, HE
    [J]. JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 1959, 38 (04) : 458 - 480
  • [10] IWASAKI M, 1994, J CARDIOVASC SURG, V35, P269