Endoscopic Diagnosis and Treatment of Iatrogenic Ruptures of the Trachea
https://doi.org/10.23934/2223-9022-2022-11-2-258-263
Abstract
Abstract Respiratory tract trauma is not only the result of injuries to the chest and neck, but may be iatrogenic as well. Diagnosis of iatrogenic damage to the trachea is based on data from clinical and instrumental studies. Among the instrumental diagnostic measures, preference is given to early fibrobronchoscopy.
The aim of the study is to assess the possibilities of fiberoptic bronchoscopy in the diagnosis of iatrogenic tracheal injuries. Materials and methods. This study analyzed the use of fiberoptic bronchoscopy in 51 patients with suspected iatrogenic damage to the trachea. For iatrogenic ruptures of the trachea, the location on the posterior (membranous) wall and the longitudinal direction (100%), as well as location in the lower and middle thoracic sections of the trachea (71.4%), are typical.
Conclusion Bronchoscopy is a direct method for diagnosing this type of damage, which allows the location, size of the defect and tactics to be accurately determined.
About the Authors
A. V. Mironov
Department of emergency surgery, endoscopy and intensive care. Department of emergency thoracoabdominal surgery N.V. Sklifosovsky Federal Research Institute of Emergency Medicine
Russian Federation
Russian Federation
Mironov, Candidate of Medical Sciences, Leading Researcher
3 B. Sukharevskaya Sq., Moscow, 129090, Russian Federation
S. N. Danielyan
Department of emergency surgery, endoscopy and intensive care. Department of emergency thoracoabdominal surgery N.V. Sklifosovsky Federal Research Institute of Emergency Medicine
Russian Federation
Russian Federation
Shagen N. Danielyan - Doctor of Medical Sciences, Leading Researcher Department of Emergency Thoracoabdominal Surgery
3 B. Sukharevskaya Sq., Moscow, 129090, Russian Federation
E. A. Tarabrin
Department of emergency surgery, endoscopy and intensive care. Department of emergency thoracoabdominal surgery N.V. Sklifosovsky Federal Research Institute of Emergency Medicine
Russian Federation
Russian Federation
Evgeny A. Tarabrin - Doctor of Medical Sciences, Head of the Department of Emergency Thoracoabdominal Surgery
3 B. Sukharevskaya Sq., Moscow, 129090, Russian Federation
References
1. Hofmann HS, Rettig G, Radke J, Neef H, Silber RE. Iatrogenic ruptures of the theracheobronchial tree. Eur J Cardiothorac Surg. 2002;21(4):649–652. PMID: 11932162 https://doi.org/10.1016/s1010-7940(02)00037-4
2. Kutlu R, Kuzucu A, Soysal O, Baysal T, Karaman I, Akbulut A. Postintubation Tracheal Rupture. Asian Cardiovascular Thorac Ann. 2001;9(2):150–152. https://doi.org/10.1177/021849230100900224
3. Parshin VD, Pogodina AN, Vyzhigina MA, Rusakov MA. Iatrogenic postitubation tracheal rupture. Russian Journal of Anаеsthesiology and Reanimatology. 2006;(2):9–13. (in Russ.).
4. Massard G, Rouge C, Dabbagh A, Kessler R, Hentz JG, Roeslin N, et al. Tracheobronchial laseration after intubation and tracheostomy. Ann Thorac Surg. 1996;61(5):1483–1487. PMID: 8633963 https://doi.org/ 10.1016/0003-4975(96)00083-5
5. Parshin VD, Vyzhigina MA, Rusakov MA, Zhukova SG, Riabova OS, Titov VA, et al. Closed tracheal injury--surgical or anesthesiologic-and-resuscitative problem. Russian Journal of Anаеsthesiology and Reanimatology. 2007;(4):50–53. (in Russ.).
6. Podkamenev VV, Kovalyova IA, Subbotina MV, Chikinda VV, Ivanov VO, Lysenko DD. Tear-Off of the Trachea in a Child: a Successful Cure Case. Russian Journal of Pediatric Surgery. 2003;(4):49–50. (in Russ.).
7. Subbotin VV, Sitnikov AV, Vishnevskiy AA. Postitubation Injuries of a Trachea. Annals of Critical Care. 2013;(3):15–23. (in Russ.).
8. Dienemann H, Hoffmann H. Tracheobronchiale Verletzungen und Fistel. Chirurg. 2001;72(10):1130–1136. PMID: 11715615 https://doi.org/10.1007/s001040170050
9. Vartanova NA. Iatrogenic Tracheal Injuries in the Practice of Anaesthesilogist. Emergency Medicine (Ukr.). 2013;(7):150–152. (in Russ.).
10. Golub IE, Pinsky SB, Netesin ES. Postintubational Damage of Trachea. Siberian Medical Journal (Irkutsk). 2009;(4):124–128. (in Russ.).
11. Romanchishen AF. Comments on the paper Ivanov AM, Novikov SD, Novikov DS. “Favorable outcome of surgical treatment of an artificial rupture of the trachea”. Grekov’s Bulletin of Surgery. 2008;167(1):106. (in Russ.).
12. Conti M, Pougeoise M, Wurtz A, Porte H, Fourrier F, Ramon P, et al. Management of postintubation tracheobronchial ruptures. Chest. 2006;130(2):412–418. PMID: 16899839 https://doi.org/10.1378/chest.130.2.412
13. Bogdanov AV, Koryachkin VA. Intubatsiya trakhei. Saint Petersburg: Sankt-Peterburgskoe meditsinskoe izdatel’stvo; 2004. (in Russ.).
14. Barbetakis N, Samanidis G, Paliouras D, Lafaras C, Bischiniotis T, Tsilikas C. Intraoperative tracheal reconstruction with bovine pericardial patch following iatrogenic rupture. Patient Saf Surg. 2008;2:4. PMID: 18289384 https://doi.org/10.1186/1754-9493-2-4
15. Tatur AA, Leonovich SI, Skachko VA, Stakhievich VA, Dzyad’zko AM, Makarenko KB, et al. Postintubatsionnye razryvy trakhei: diagnostika, lechenie i profilaktika. Medical Journal (Bel). 2008;(3):83–86. (in Russ.).
16. Singh S, Gurney S. Management of post-intubation tracheal membrane ruptures: A practical approach. Indian J Crit Care Med. 2013;17(2):99–103. PMID: 23983415 https://doi.org/10.4103/0972-5229.114826
17. Welter S, Hoffmann H. Injuries to the tracheo-bronchial tree. Zentralbl Chir. 2013;138(1):111–116. PMID: 23450402 https://doi.org/doi: 10.1055/s-0032-1328269
18. Lee SK, Kim DH, Lee SK, Kim YD, Cho JS, Hoseok I. Does Surgical Repair Still have a Role for Iatrogenic Tracheobronchial Rupture? Clinical Analysis of a Thoracic Surgeon’s Opinion. Ann Thorac Cardiovasc Surg. 2016;22(6):348–353. PMID: 27840372 https://doi.org/doi:10.5761/atcs.oa.16-00189
19. Gil T, Warmus J, Włodarczyk J, Grochowski Z, Bederski K, Kocoń P, et al. Iatrogenic injuries to the trachea and main bronchi. Kardiochir Torakochirurgia Pol. 2016;13(2):113–116. PMID: 27516782 https://doi.org/10.5114/kitp.2016.61043
20. Pogodina AN, Nikolaeva EB, Boldin DA. Diagnostika i lechenie yatrogennykh povrezhdeniy trakhei. In: Povrezhdeniya pishchevoda i trakhei i ikh oslozhneniya: materialy gorodskogo seminara. Moscow: NII SP im. N.V. Sklifosovskogo Publ.; 2009. (Trudy instituta, Vol. 210). pp. 6–10. (in Russ.)]
21. Chen E.N., Logman Z, Glass P, Bilfinger T. A case of tracheal injury after emergent endotracheal intubation: a review of the literature and causalities. Anesth Analg. 2001;93(5):1270–1271. PMID: 11682412 https://doi.org/10.1097/00000539-200111000-00047
22. Paraschiv M. Iatrogenic tracheobronchial rupture. J Med Life. 2014;7(3):343–348. PMID: 25408752
23. Eliçora A, Akgül AG, Topçu S, Özbay S, Hoşten T, Sezer HF, et al. Management of Post-Intubation Tracheal Membrane Ruptures. Arch Iran Med. 2016;19(7):491–495. PMID: 27362243
24. Stolyarov SI, Dobrov AV, Grigoryev VL, Arsutov VP, Lepeshkin AP, Ryzhkov RV. Surgical Approach in Postintubation Damage of the Trachea. Healthcare of Chuvashia. 2018;(2):18–24. (in Russ.) https://doi.org/10.25589/GIDUV.2018.55.12317
25. Madden BP. Evolutional trends in the management of tracheal and bronchial injuries. J Thorac Dis. 2017;9(1):E67–E70. PMID: 28203439 https://doi.org/10.21037/jtd.2017.01.43
26. Wei P, Yan D, Huang J, Dong L, Zhao Y, Rong F, et al. Anesthetic management of tracheal laceration from traumatic dislocation of the first rib: a case report and literature of the review. BMC Anesthesiol. 2019;19(1):149. PMID: 31399024 https://doi.org/10.1186/s12871-019-0812-9
27. Welter S, Essaleh W. Management of tracheobronchial injuries. J Thorac Dis. 2020;12(10):6143–6151. PMID: 33209452 https://doi.org/10.21037/jtd-2019-as-05
28. Mussi A, Ambrogi MC, Menconi G, Ribechini A, Angeletti CA. Surgical approaches to membranous tracheal wall lacerations. J Thorac Cardiovasc Surg. 2000;120(1):115–118. PMID: 10884663 https://doi.org/10.1067/mtc.2000.107122
Review
For citations:
Mironov A.V., Danielyan S.N., Tarabrin E.A. Endoscopic Diagnosis and Treatment of Iatrogenic Ruptures of the Trachea. Russian Sklifosovsky Journal "Emergency Medical Care". 2022;11(2):258-263. https://doi.org/10.23934/2223-9022-2022-11-2-258-263
Views:
743
Email this article 