Surgical approach to the tracheal trauma

Objective: Tracheo-bronchial ruptures are rare but potentially life threatening. We wanted to evaluate the role of surgical therapy. Methods: We reviewed our experince with 10 consecutive patients (pts) (4 male and 6 female) with tracheobronchial injuries treated over a 7-years period. Results: All pts underwent primary repair through a right postero-lateral thoracotomy (n=5) or a cervical collar incision (n=5) associated with a longitudinal tracheotomy in 2 cases. Results were uniformly good. Conclusions: Early surgical repair is the preferred treatment for most pts with tracheobronchial ruptures. Lower third tracheal injuries require a thoracotomy above all If they involve a main bronchus. Upper and middle third ruptures may be treated through a low cervical incision; in this location a membranous tracheal laceration can also be repaired using a mediastinoscopy incision associated with a longitudinal tracheotomy.