title: Major airway injury during esophagectomy: experience at a tertiary care center.
abstract: BACKGROUND
  Tracheal laceration is a rare but life-threatening complication of esophagectomy. It is seen both with transhiatal and transthoracic esophagectomy.
  
  
  METHODS
  Three hundred eighty-two esophagectomies were performed from 1998 to 2008. The medical records of five patients with laceration of trachea during esophagectomy managed at a tertiary care center were reviewed retrospectively.
  
  
  RESULTS
  There were three males and two females with age range 18-62 years. The overall incidence of tracheal laceration was 1.31%. Four lacerations (1.30%) occurred during transhiatal and one (1.35%) during transthoracic resection of esophagus. Tracheal laceration was detected intraoperatively in all. Laceration was long (>3 cm) in three patients and short (<2 cm) in two. Patients with long laceration required direct suturing, while those with short laceration could be managed with gastric reinforcement. No patient required additional thoracotomy to access the lesion. Two patients had pneumonia, one had recurrent nerve palsy, while another developed anastomotic disruption. No patient died.
  
  
  CONCLUSIONS
  Laceration of trachea is a potentially morbid complication of esophagectomy. Management should be individualized based on the extent and type of laceration. The surgical strategy depends upon the index procedure. The present series describes successful management of patients with tracheal injury associated with esophagectomy.
authors.affiliation: Department of General Surgery (Division of Gastrointestinal Surgery), Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India. vggispgi@hotmail.com
authors.forename: Vikas
authors.initials: V
authors.lastname: Gupta
authors.forename: Rajesh
authors.initials: R
authors.lastname: Gupta
authors.forename: Shyam K S
authors.initials: SK
authors.lastname: Thingnam
authors.forename: Rana S
authors.initials: RS
authors.lastname: Singh
authors.forename: Ashok K
authors.initials: AK
authors.lastname: Gupta
authors.forename: Sachin
authors.initials: S
authors.lastname: Kuthe
authors.forename: Narendar M
authors.initials: NM
authors.lastname: Gupta
mesh_terms: D000293:Adolescent; D015331:Cohort Studies; D016629:Esophagectomy / Q000009:adverse effects* / Q000379:methods; D005260:Female; D006801:Humans; D007441:Intubation, Gastrointestinal; D022125:Lacerations / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D013536:Suture Techniques; D014132:Trachea / Q000293:injuries*; D016896:Treatment Outcome