title: Tracheobronchial lacerations after intubation and tracheostomy.
abstract: BACKGROUND
  Although long-term complications of intubation and tracheostomy are well documented, little has been reported on acute complications of airway access techniques.
  
  
  METHODS
  Fourteen patients (1 male and 13 female patients) aged 15 to 80 years presented with tracheobronchial lacerations after single-lumen intubation (n = 9), double-lumen intubation (n = 1), or tracheostomy (n = 4).
  
  
  RESULTS
  A left bronchial laceration after double-lumen intubation was discovered and repaired intraoperatively. A tracheal laceration after single-lumen intubation was recognized during induction of anesthesia. The remaining 12 were diagnosed within 6 to 126 hours (median, 24 hours) after injury. All patients had mediastinal and subcutaneous emphysema. At endoscopy, 12 injuries were located in the thoracic trachea and 1 in the cervical trachea. Twelve underwent primary repair through a right thoracotomy (n = 11) or left cervicotomy (n = 1), and 1 was treated conservatively. Two patients with tracheostomy injury died postoperatively. All repairs healed well but one. The latter was performed 5 days after the injury; a dehiscence occurred, but healed spontaneously.
  
  
  CONCLUSIONS
  We conclude that prognosis of tracheal lacerations depends both on the general health of the patient and on the rapidity of diagnosis and treatment.
authors.affiliation: Department of Thoracic Surgery, University Hospital of Strasbourg, France.
authors.forename: G
authors.initials: G
authors.lastname: Massard
authors.forename: C
authors.initials: C
authors.lastname: Rougé
authors.forename: A
authors.initials: A
authors.lastname: Dabbagh
authors.forename: R
authors.initials: R
authors.lastname: Kessler
authors.forename: J G
authors.initials: JG
authors.lastname: Hentz
authors.forename: N
authors.initials: N
authors.lastname: Roeslin
authors.forename: J M
authors.initials: JM
authors.lastname: Wihlm
authors.forename: G
authors.initials: G
authors.lastname: Morand
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001980:Bronchi / Q000293:injuries*; D005260:Female; D006801:Humans; D007049:Iatrogenic Disease; D007442:Intubation, Intratracheal / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014132:Trachea / Q000293:injuries*; D014139:Tracheostomy / Q000009:adverse effects*