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Incidence and treatment modalities of tracheobronchial injuries in Germany

Department of Thoracic Surgery, Thoraxklinik, University of Heidelberg, Heidelberg, Germany

*Corresponding author. Department of Thoracic Surgery, Thoraxklinik am Universitätsklinikum Heidelberg, Amalienstrasse 5, D-69126 Heidelberg, Germany. Tel.: +49-6221-396-1100; fax: +49-6221-396-1102.

E-mail address: hans.hoffmann{at}urz.uni-heidelberg.de (H. Hoffmann).

This study presents the first systematic data collection on incidence and therapeutic management of both iatrogenic and non-iatrogenic tracheal lacerations in Germany. In this survey (n=231 questionnaires) based on the geographical coverage of the country, the representation of all levels of service, and the inclusion of specialized thoracic departments as well as non-specialized surgical departments, a representative conspectus on the management of tracheal injuries in Germany was developed. A total number of 1033 tracheal injuries were reported; n=429 of non-iatrogenic origin (blunt trauma: n=276, penetrating wounds: n=94, bullet wounds: n=16, other etiology: n=43) and n=604 of iatrogenic origin (endotracheal intubations/mechanical ventilation: n=372, dilative tracheotomy: n=181, endoscopic interventions: n=51). In institutions of high level of service there was a trend towards higher rates of surgical repair as opposed to conservative management. On the basis of these data the estimated risk of tracheal lacerations, due to single lumen intubation was 1:75,000 (0.000013%); the risk of clinically significant tracheal lacerations due to dilative tracheostomy 1:575 (0.002%) and lacerations requiring surgical treatment 1:975 (0.001%). Data of this survey state that specialized thoracic surgeons to a high proportion are involved in the management of both iatrogenic and non-iatrogenic tracheal injuries.

Key Words: Tracheal injury; Tracheal surgery; Incidence; Iatrogenic tracheal injury

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