title: Does Surgical Repair Still have a Role for Iatrogenic Tracheobronchial Rupture? Clinical Analysis of a Thoracic Surgeon's Opinion.
abstract: OBJECTIVE
  The choice of surgical repair or conservative treatment for iatrogenic tracheobronchial rupture (ITBR) remains controversial. However, thoracic surgeons consider that surgical repair is an important treatment modality. The purpose of this study was to evaluate the clinical results from the perspective of the surgery-preferred group.
  
  
  METHODS
  We treated 11 patients (8 women and 3 men; age: 52.6 ± 22.9 years) with ITBR from January 2011 to January 2016. A posterolateral thoracotomy or a trans-tracheal approach was performed according to the mechanism of injury.
  
  
  RESULTS
  Nine patients underwent surgery, and all patients received primary repair. Five patients received a right posterolateral thoracotomy, whereas one patient received a left posterolateral thoracotomy. No mortality or morbidity related to the surgery was observed. The mechanical ventilation time was 65.9 ± 99.2 hours. The intensive care unit duration was 19.7 ± 33.3 days. Two patients received conservative treatment, and all patients died of another disease that was not related to the conservative treatment.
  
  
  CONCLUSIONS
  Our mortality or morbidity due to surgery was not higher than world literature results of conservative treatment. We thought surgery is the primary treatment choice for ITBR in the absence of a good indication for conservative treatment.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Gyoungnam, Korea.
authors.forename: Sung Kwang
authors.initials: SK
authors.lastname: Lee
authors.forename: Do Hyung
authors.initials: DH
authors.lastname: Kim
authors.forename: Sang Kwon
authors.initials: SK
authors.lastname: Lee
authors.forename: Yeong-Dae
authors.initials: YD
authors.lastname: Kim
authors.forename: Jeong Su
authors.initials: JS
authors.lastname: Cho
authors.forename: Hoseok
authors.initials: H
authors.lastname: I
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001980:Bronchi / Q000293:injuries / Q000601:surgery*; D002648:Child; D005260:Female; D006801:Humans; D007049:Iatrogenic Disease; D007442:Intubation, Intratracheal / Q000009:adverse effects*; D007902:Length of Stay; D055370:Lung Injury / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D012121:Respiration, Artificial; D012189:Retrospective Studies; D012307:Risk Factors; D012421:Rupture; D013536:Suture Techniques / Q000009:adverse effects; D013908:Thoracotomy / Q000009:adverse effects; D013997:Time Factors; D014132:Trachea / Q000293:injuries / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult