%0 Journal Article %1 Leinung.2005 %A Leinung, S. %A Ott, R. %A Schuster, Ernst %A Eichfeld, U. %D 2005 %J Der Chirurg; Zeitschrift für alle Gebiete der operativen Medizen %K IMISE-Publikationen %N 8 %P 783–788 %T Tracheobronchiale Verletzungen Klassifikation und Therapiestrategie %V 76 %X BACKGROUND Tracheobronchial ruptures are rare surgical emergencies with significant mortality. We present management and outcome of such ruptures treated at the University of Leipzig in Germany and propose a novel therapeutic algorithm-a new classification system for stratifying treatment of patients with tracheobronchial ruptures. METHODS We retrospectively studied 24 patients 19 to 88 years old who were treated in our institution for tracheobronchial injury. RESULTS Eighty-seven percent of the injuries were caused iatrogenically. Fifty-four percent were type I injuries (isolated tracheal lesions), 38\% type II (involvement of carina or main stem bronchi), and 8\% type III (distal lesions of lobar or segmental bronchi). Seventy-five percent of the patients were operated via right-sided dorsolateral thoracotomy. In four (22\%), insufficiency of the tracheal closure occurred, with mediastinitis possibly being a significant risk factor for this event (P<0.001). In surgically treated patients, rupture-related and overall mortality were 5.5\% and 28\%, respectively, whereas in medically treated patients, mortality was 33\%. CONCLUSION The proposed classification of tracheobronchial injuries enables stratifying the treatment of patients with tracheobronchial ruptures. Type I lesions can be surgically closed either by a right-sided thoracotomy or transcervical-transtracheal approach. In contrast, surgical management of type II and III injuries always requires thoracotomy.

@article{Leinung.2005, abstract = {BACKGROUND Tracheobronchial ruptures are rare surgical emergencies with significant mortality. We present management and outcome of such ruptures treated at the University of Leipzig in Germany and propose a novel therapeutic algorithm-a new classification system for stratifying treatment of patients with tracheobronchial ruptures. METHODS We retrospectively studied 24 patients 19 to 88 years old who were treated in our institution for tracheobronchial injury. RESULTS Eighty-seven percent of the injuries were caused iatrogenically. Fifty-four percent were type I injuries (isolated tracheal lesions), 38\% type II (involvement of carina or main stem bronchi), and 8\% type III (distal lesions of lobar or segmental bronchi). Seventy-five percent of the patients were operated via right-sided dorsolateral thoracotomy. In four (22\%), insufficiency of the tracheal closure occurred, with mediastinitis possibly being a significant risk factor for this event (P<0.001). In surgically treated patients, rupture-related and overall mortality were 5.5\% and 28\%, respectively, whereas in medically treated patients, mortality was 33\%. CONCLUSION The proposed classification of tracheobronchial injuries enables stratifying the treatment of patients with tracheobronchial ruptures. Type I lesions can be surgically closed either by a right-sided thoracotomy or transcervical-transtracheal approach. In contrast, surgical management of type II and III injuries always requires thoracotomy.}, added-at = {2014-10-15T15:04:09.000+0200}, author = {Leinung, S. and Ott, R. and Schuster, Ernst and Eichfeld, U.}, biburl = {https://www.bibsonomy.org/bibtex/2af113f57cbaa13d65589e5727b51cbc7/drtester}, interhash = {ab40ddb953c6f54e54a42e08588f8a9e}, intrahash = {af113f57cbaa13d65589e5727b51cbc7}, journal = {Der Chirurg; Zeitschrift für alle Gebiete der operativen Medizen}, keywords = {IMISE-Publikationen}, number = 8, pages = {783–788}, timestamp = {2014-12-03T00:08:47.000+0100}, title = {Tracheobronchiale Verletzungen Klassifikation und Therapiestrategie}, volume = 76, year = 2005 }