title: Iatrogenic injuries to the trachea and main bronchi.
abstract: BACKGROUND
  Iatrogenic tracheobronchial injuries are rare.
  
  
  OBJECTIVE
  To analyse the mechanism of injury, symptoms and treatment of these patients.
  
  
  METHODS
  Retrospective analysis of hospital records of all patients treated for main airway injuries between 1990 and 2012 was performed.
  
  
  RESULTS
  There were 24 patients, including 21 women and 3 men. Mean time between injury and initiation of treatment was 12 hours (range: 2-48). In 16 patients the injury occurred during tracheal intubation, in 1 during rigid bronchoscopy, in 1 during rigid oesophagoscopy, in 1 during mediastinoscopy and in 5 during open surgery. Mean length of airway tear was 3.8 cm (range: 1.5-8). In 1 patient there was an injury to the cervical trachea and in the remaining 23 in the thoracic part of the airway. The treatment included repair of the membranous part of the trachea performed via right thoracotomy in 10 patients (in 1 patient additionally coverage with a pedicled intercostal muscle flap was used), a self-expanding metallic stent in 1 patient, suture of the right main bronchus and the oesophagus in 1, left upper sleeve lobectomy in 1, right upper lobectomy in 1, implantation of a silicone Y stent in 3, mini-tracheostomy in 1, and conservative treatment in 5 patients.
  
  
  CONCLUSIONS
  Intubation is the most frequent cause of iatrogenic main airway injuries. Patients with these life-threatening complications require an individualised approach and treatment in a reference centre.
authors: Department of Thoracic Surgery, Jagiellonian University Medical College, John Paul II Hospital, Krakow, Poland.
authors: Tomasz
authors: T
authors: Gil
authors: Department of Thoracic Surgery, Jagiellonian University Medical College, John Paul II Hospital, Krakow, Poland.
authors: Janusz
authors: J
authors: Warmus
authors: Department of Thoracic Surgery, Jagiellonian University Medical College, John Paul II Hospital, Krakow, Poland.
authors: Janusz
authors: J
authors: Włodarczyk
authors: Department of Thoracic Surgery, Jagiellonian University Medical College, John Paul II Hospital, Krakow, Poland.
authors: Zbigniew
authors: Z
authors: Grochowski
authors: Department of Thoracic Surgery, Jagiellonian University Medical College, John Paul II Hospital, Krakow, Poland.
authors: Krzysztof
authors: K
authors: Bederski
authors: Department of Thoracic Surgery, Jagiellonian University Medical College, John Paul II Hospital, Krakow, Poland.
authors: Piotr
authors: P
authors: Kocoń
authors: Department of Thoracic Surgery, Jagiellonian University Medical College, John Paul II Hospital, Krakow, Poland.
authors: Piotr
authors: P
authors: Talar
authors: Department of Thoracic Surgery, Jagiellonian University Medical College, John Paul II Hospital, Krakow, Poland.
authors: Jarosław
authors: J
authors: Kużdżał
keywords: airway; iatrogenic injury; trachea