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Iatrogenic tracheobronchial ruptures – treatment and outcomes

^a Thoracic Surgery Unit, Centre of Surgery, University of Leipzig, Liebigstraße 20, D-04103 Leipzig, Germany
^b Department of Cardio-Thoracic Surgery, Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Straße 40, D-06097 Halle, Germany
^c Department of Anesthesiology and Intensive Care Medicine, University of Leipzig, Liebigstraße 20, D-04103 Leipzig, Germany
^d Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, Härtelstr. 16–18, D-04107 Leipzig, Germany

*Corresponding autor. Tel.: +49 341 9719968; fax: +49 341 9717009.

E-mail address: Steffen.Leinung{at}medizin.uni-leipzig.de (S. Leinung).

In the present paper we discuss the indication and follow-up of 42 patients with iatrogenic tracheobrochial ruptures. Thirty-five patients were treated by operation and 7 patients were treated conservatively. In the operated patients, four developed an insufficiency of the tracheal closure and the rupture related mortality was 2.8%. A significant effect on suture dehiscence was seen for mediastinitis (P<0.005) prior to operation, prior resection of the esophagus (P<0.001), and a long delay between injury and diagnosis (P=0.004). In the conservatively treated group the rupture related mortality was 29%. In conclusion to our results we suggest a surgical procedure whenever a tracheobronchial rupture is diagnosed and the patient's constitution allows the surgical procedure or anesthesia.

Key Words: Trachea; Bronchus; Rupture; Suture; Outcomes