title: Intraoperative management of tracheobronchial rupture after double-lumen tube intubation.
abstract: OBJECTIVE
  Tracheobronchial rupture is an uncommon but potentially serious complication of endotracheal intubation. In this study, the diagnosis and treatment strategies of a specific group of ruptures caused by double-lumen tube intubation are herein presented.
  
  
  METHODS
  The medical records of 18 patients diagnosed and treated for tracheobronchial rupture after undergoing double-lumen tube intubation between January 1999 and October 2010 are analyzed retrospectively.
  
  
  RESULTS
  In all cases, the ruptures occurred in the membranous portion. The average length of laceration was 2.44 ± 1.78 cm. The most common site of rupture was in the lower third of the trachea (n = 7, 39 %) or the left mainstem bronchus (n = 7, 39 %). One patient was diagnosed before incision using fiberoptic bronchoscopy, and 17 patients were diagnosed using direct vision of the rupture intraoperatively. All patients were treated successfully with surgery. There were no morbidities or mortalities recorded in relation to tracheobronchial rupture.
  
  
  CONCLUSIONS
  Thoracic surgeons must be alerted to the possibility for tracheobronchial rupture in patients intubated with double-lumen tubes, a procedure commonly used in thoracic surgery. Immediate repair must be performed for any laceration diagnosed intraoperatively.
authors.affiliation: Department of Thoracic Surgery, Dr. Suat Seren Chest Diseases and Thoracic Surgery Research and Training Hospital, Izmir, Turkey. kcanceylan@gmail.com
authors.forename: Kenan Can
authors.initials: KC
authors.lastname: Ceylan
authors.forename: Seyda Ors
authors.initials: SO
authors.lastname: Kaya
authors.forename: Ozgur
authors.initials: O
authors.lastname: Samancilar
authors.forename: Ozan
authors.initials: O
authors.lastname: Usluer
authors.forename: Soner
authors.initials: S
authors.lastname: Gursoy
authors.forename: Ahmet
authors.initials: A
authors.lastname: Ucvet
mesh_terms: D000328:Adult; D000368:Aged; D001980:Bronchi / Q000293:injuries* / Q000601:surgery; D005260:Female; D006801:Humans; D007430:Intraoperative Care; D007431:Intraoperative Complications / Q000209:etiology* / Q000601:surgery*; D007442:Intubation, Intratracheal / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012421:Rupture; D019616:Thoracic Surgical Procedures; D014132:Trachea / Q000293:injuries* / Q000601:surgery