Janni A, Menconi G, Mussi A, Ambrogi M C, Angeletti C A
Cardiac and Thoracic Department, University of Pisa, Italy.
Ann Thorac Surg. 2000 Jan;69(1):243-4. doi: 10.1016/s0003-4975(99)01319-3.
Membranous tracheal lacerations are a serious complication of endotracheal intubation. Smaller tears are often better managed with a conservative treatment. Larger ruptures, especially when associated with important manifestations, need an early surgical repair.
In the last 3 years, three female patients with a posterior tracheal wall laceration, related to endotracheal intubation, underwent surgical procedure in our institution. All tracheal tears were repaired with a running suture through a small cervical collar incision and longitudinal tracheotomy.
All surgical procedures were effective and lasted less than 1 hour. Patients were discharged on average after 5 days. Endoscopic follow-up showed a perfect repair of the tear without signs of tracheal stenosis.
This is a reliable, quick, and safe approach to a rare but insidious complication of general anesthesia. It avoids lateral and posterior dissection of the trachea, reducing the risk of a recurrent laryngeal nerve injury.
气管膜部撕裂是气管插管的严重并发症。较小的撕裂伤通常采用保守治疗效果更佳。较大的破裂口，尤其是伴有重要临床表现时，需要早期手术修复。
在过去3年中，我院有3例因气管插管导致气管后壁撕裂的女性患者接受了手术治疗。所有气管撕裂伤均通过颈部小切口和纵向气管切开术采用连续缝合进行修复。
所有手术均有效，且持续时间不到1小时。患者平均5天后出院。内镜随访显示撕裂伤完全修复，无气管狭窄迹象。
这是一种针对全身麻醉罕见但隐匿并发症的可靠、快速且安全的方法。它避免了气管的外侧和后侧解剖，降低了喉返神经损伤的风险。
