TRACHEOBRONCHIAL LACERATIONS AFTER INTUBATION AND TRACHEOSTOMY

Background. Although long-term complications of intubation and tracheo stomy are well documented, little has been reported on acute complicat ions of airway access techniques. Methods. Fourteen patients (1 male a nd 13 female patients) aged 15 to 80 years presented with tracheobronc hial lacerations after single-lumen intubation (n = 9), double-lumen i ntubation (n = 1), or tracheostomy (n = 4). Results. A left bronchial laceration after double-lumen intubation was discovered and repaired i ntraoperatively. A tracheal laceration after single-lumen intubation w as recognized during induction of anesthesia. The remaining 12 were di agnosed within 6 to 126 hours (median, 24 hours) after injury. All pat ients had mediastinal and subcutaneous emphysema. At endoscopy, 12 inj uries were located in the thoracic trachea and 1 in the cervical trach ea. Twelve underwent primary repair through a right thoracotomy (n = 1 1) or left cervicotomy (n = 1), and 1 was treated conservatively. Two patients with tracheostomy injury died postoperatively. All repairs he aled well but one. The latter was performed 5 days after the injury; a dehiscence occurred, but healed spontaneously. Conclusions. We conclu de that prognosis of tracheal lacerations depends both on the general health of the patient and on the rapidity of diagnosis and treatment.