Tracheal injuries, independent of their origin, may be life-threatening. Surgical repair is regarded as the treatment of choice but has not been compared with other approaches. We hypothesized that defects bridgeable by an artificial airway may enable conservative treatment. We report on five patients with tracheal injuries, two in the trachea's upper third resulting from trauma and intubation and three in its middle third after percutaneous dilational tracheostomy. Tracheal defects were bridged by endotracheal or tracheostomy tubes under bronchoscopic guidance and the cuff was inflated distal to the lesion. Air leakage stopped immediately and all tracheal defects healed without further interventions. No case of stenosis or mediastinitis was observed. These results suggest that treating tracheal injuries conservatively by placing an artificial airway under bronchoscopic guidance may be effective and offers a convenient starting position for secondary surgical repair in selected patients when conservative treatment fails.
机构:
Washington Univ, Sch Med, Dept Surg, Sect Burn Trauma Surg Crit Care, St Louis, MO 63110 USAWashington Univ, Sch Med, Dept Surg, Sect Burn Trauma Surg Crit Care, St Louis, MO 63110 USA
Freeman, BD
;
Isabella, K
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Washington Univ, Sch Med, Dept Surg, Sect Burn Trauma Surg Crit Care, St Louis, MO 63110 USAWashington Univ, Sch Med, Dept Surg, Sect Burn Trauma Surg Crit Care, St Louis, MO 63110 USA
Isabella, K
;
Lin, N
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Washington Univ, Sch Med, Dept Surg, Sect Burn Trauma Surg Crit Care, St Louis, MO 63110 USAWashington Univ, Sch Med, Dept Surg, Sect Burn Trauma Surg Crit Care, St Louis, MO 63110 USA
Lin, N
;
Buchman, TG
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Washington Univ, Sch Med, Dept Surg, Sect Burn Trauma Surg Crit Care, St Louis, MO 63110 USAWashington Univ, Sch Med, Dept Surg, Sect Burn Trauma Surg Crit Care, St Louis, MO 63110 USA
机构:
Washington Univ, Sch Med, Dept Surg, Sect Burn Trauma Surg Crit Care, St Louis, MO 63110 USAWashington Univ, Sch Med, Dept Surg, Sect Burn Trauma Surg Crit Care, St Louis, MO 63110 USA
Freeman, BD
;
Isabella, K
论文数: 0引用数: 0
h-index: 0
机构:
Washington Univ, Sch Med, Dept Surg, Sect Burn Trauma Surg Crit Care, St Louis, MO 63110 USAWashington Univ, Sch Med, Dept Surg, Sect Burn Trauma Surg Crit Care, St Louis, MO 63110 USA
Isabella, K
;
Lin, N
论文数: 0引用数: 0
h-index: 0
机构:
Washington Univ, Sch Med, Dept Surg, Sect Burn Trauma Surg Crit Care, St Louis, MO 63110 USAWashington Univ, Sch Med, Dept Surg, Sect Burn Trauma Surg Crit Care, St Louis, MO 63110 USA
Lin, N
;
Buchman, TG
论文数: 0引用数: 0
h-index: 0
机构:
Washington Univ, Sch Med, Dept Surg, Sect Burn Trauma Surg Crit Care, St Louis, MO 63110 USAWashington Univ, Sch Med, Dept Surg, Sect Burn Trauma Surg Crit Care, St Louis, MO 63110 USA