POST-INTUBATION TRACHEAL RUPTURE - A REPORT ON 10 CASES

Objective: We wanted to evaluate the role of surgical and conservative therapy in the treatment of post-intubation tracheal rupture. Methods : A retrospective study was performed on 10 consecutive patients (9 wo men and 1 man) treated over a 7-year period. Results: A tracheal ruptu re following double-lumen intubation was recognized and repaired at th e time of lobectomy for lung cancer. Five patients with rents ranging from 2.5 cm to 5 cm underwent primary repair through a cervical collar incision (n = 3) or right posterolateral thoracotomy (a = 2). Three p atients had small tears (about 1 tm in length) and were treated conser vatively. Tracheostomy was performed in one patient with a 1.5-cm long laceration and extensive subcutaneous emphysema. Results were uniform ly good. Conclusions: Early surgical repair is the preferred treatment for most patients with post-intubation tracheal ruptures. Conservativ e treatment may be a viable alternative for patients with small rents, in the absence of gross air leak, or for those judged unsuitable for surgery. The role of tracheostomy is limited by its potential for late sequelae. (C) 1997 Elsevier Science B.V.