Rupture of left main bronchus associated with radiotherapy-induced bronchial injury and use of a double-lumen tube in oesophageal cancer surgery.
We report a case of rupture of the left main bronchus in a female patient with oesophageal carcinoma, who had received thoracic radiotherapy preoperatively. Endotracheal intubation was achieved with a left-sided double-lumen tube. After almost three hours of intubation and one and half hours of one-lung ventilation, bronchial injury was detected. Immediate surgical repair of the membranous part of the bronchus was undertaken, as well as completion of the oesophagectomy. Radiotherapy-induced damage to the bronchus was thought to have contributed to the rupture. The presentation, diagnosis and management of intraoperative bronchial rupture are discussed.
Jha
R R
RR
Department of Anesthesiology, Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India.
Mishra
S
S
Bhatnagar
S
S
D001980:Bronchi / Q000293:injuries / Q000528:radiation effects* / Q000601:surgery; D003131:Combined Modality Therapy; D004938:Esophageal Neoplasms / Q000532:radiotherapy* / Q000601:surgery; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal / Q000009:adverse effects* / Q000295:instrumentation; D008875:Middle Aged; D011300:Preoperative Care; D011832:Radiation Injuries / Q000150:complications*; D011878:Radiotherapy / Q000009:adverse effects*; D012421:Rupture / Q000209:etiology; D013536:Suture Techniques