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Nonoperative Management of Tracheobronchial Injuries in Severely Injured Patients

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Abstract

Purpose

A rupture of the airway due to blunt chest trauma is rare, and treatment can prove challenging. Many surgeons suggest operative management for these kinds of injuries. Nonoperative therapy is reported only in exceptional cases. But there is still a lack of evidence from which to recommend surgical repair of these injuries as the first choice procedure.

Methods

We retrospectively analyzed the records of 92 multiple injured patients admitted to our trauma department between July 2002 and July 2003 for the incidence and management of tracheobronchial rupture (TBR).

Results

Five (5.4%) of 92 patients suffered from tracheobronchial injuries. The mean injury severity score was 38. There were three male and two female patients, with a mean age of 23 years. All patients had lesions <2 cm in size and were treated nonoperatively. One patient died from multiorgan failure, but the others recovered from TBR uneventfully. One patient developed acute pneumonia as a result of respirator therapy, but none of the patients had mediastinitis or tracheal stenosis within 3 months after injury.

Conclusion

We believe that surgical treatment is not mandatory in patients with small to moderate ruptures, and such aggressive treatment may even have adverse effects, especially in patients with multiple injuries.

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Authors and Affiliations

  1. Departments of Traumasurgery, University Hospital of Essen, Germany

    Christian A. Kuhne, Sascha Flohe, Christian Waydhas, Sven Lendemanns, Thomas Paffrath & Dieter Nast-Kolb

  2. Departments of General Surgery and Transplantation, University Hospital of Essen, Germany

    Gernot M. Kaiser & Gregor A. Stavrou

  3. Departments of Anaesthesia and Critical Care Medicine, University Hospital of Essen, Germany

    Martin Beiderlinden

  4. Departments of Diagnostic and Interventional Radiology, University Hospital of Essen, Germany

    Hilmar Kuehl

Authors
  1. Christian A. Kuhne
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  2. Gernot M. Kaiser
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  3. Sascha Flohe
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  4. Martin Beiderlinden
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  7. Christian Waydhas
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  9. Thomas Paffrath
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Kuhne, C., Kaiser, G., Flohe, S. et al. Nonoperative Management of Tracheobronchial Injuries in Severely Injured Patients. Surg Today 35, 518–523 (2005). https://doi.org/10.1007/s00595-005-3001-z

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  • DOI: https://doi.org/10.1007/s00595-005-3001-z

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