Lee Sung Kwang, Kim Do Hyung, Lee Sang Kwon, Kim Yeong-Dae, Cho Jeong Su, I Hoseok
Department of Thoracic and Cardiovascular Surgery, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Gyoungnam, Korea.
Ann Thorac Cardiovasc Surg. 2016 Dec 20;22(6):348-353. doi: 10.5761/atcs.oa.16-00189. Epub 2016 Nov 14.
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.
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.
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.
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.
对于医源性气管支气管破裂（ITBR），手术修复或保守治疗的选择仍存在争议。然而，胸外科医生认为手术修复是一种重要的治疗方式。本研究的目的是从倾向手术治疗的组的角度评估临床结果。
2011年1月至2016年1月，我们治疗了11例ITBR患者（8名女性和3名男性；年龄：52.6±22.9岁）。根据损伤机制行后外侧开胸手术或经气管入路手术。
9例患者接受了手术，所有患者均接受了一期修复。5例患者行右后外侧开胸手术，1例患者行左后外侧开胸手术。未观察到与手术相关的死亡或并发症。机械通气时间为65.9±99.2小时。重症监护病房住院时间为19.7±33.3天。2例患者接受了保守治疗，所有患者均死于与保守治疗无关的其他疾病。
我们手术导致的死亡率或并发症发生率不高于世界文献中保守治疗的结果。我们认为在没有保守治疗的良好指征时，手术是ITBR的主要治疗选择。
