Department of Thoracic Surgery, Dr. Suat Seren Chest Diseases and Thoracic Surgery Research and Training Hospital, Izmir, Turkey.
Surg Today. 2013 Jul;43(7):757-62. doi: 10.1007/s00595-012-0315-5. Epub 2012 Sep 6.
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.
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.
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.
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.
气管支气管破裂是气管插管的一种罕见但潜在严重的并发症。本研究旨在介绍一组因双腔管插管引起的特定类型气管支气管破裂的诊断和治疗策略。
回顾性分析 1999 年 1 月至 2010 年 10 月期间因双腔管插管后诊断为气管支气管破裂并接受治疗的 18 例患者的病历资料。
所有患者的破裂均发生在膜部，裂伤平均长度为 2.44 ± 1.78 cm。最常见的破裂部位为气管下段（n = 7，39%）或左主支气管（n = 7，39%）。1 例患者在切开前通过纤维支气管镜诊断，17 例患者在术中直视下诊断破裂。所有患者均成功接受手术治疗。与气管支气管破裂相关，无患者发生并发症或死亡。
胸外科医生必须警惕双腔管插管患者发生气管支气管破裂的可能性，该操作常用于胸外科。对于术中诊断的任何裂伤，均应立即进行修复。
