Post-intubation tracheal lacerations: Risk-stratification and treatment protocol according to morphological classification.

Autor:	Cardillo G; Unit of Thoracic Surgery, Azienda Ospedaliera San Camillo-Forlanini, Carlo Forlanini Hospital, Rome, Italy.; Unicamillus-Saint Camillus University of Health Sciences, Rome, Italy., Ricciardi S; Unit of Thoracic Surgery, Azienda Ospedaliera San Camillo-Forlanini, Carlo Forlanini Hospital, Rome, Italy.; PhD Program, Alma Mater Studiorum, University of Bologna, Bologna, Italy., Forcione AR; Unit of Thoracic Surgery, Azienda Ospedaliera San Camillo-Forlanini, Carlo Forlanini Hospital, Rome, Italy., Carbone L; Unit of Thoracic Surgery, Azienda Ospedaliera San Camillo-Forlanini, Carlo Forlanini Hospital, Rome, Italy., Carleo F; Unit of Thoracic Surgery, Azienda Ospedaliera San Camillo-Forlanini, Carlo Forlanini Hospital, Rome, Italy., Di Martino M; Unit of Thoracic Surgery, Azienda Ospedaliera San Camillo-Forlanini, Carlo Forlanini Hospital, Rome, Italy., Jaus MO; Unit of Thoracic Surgery, Azienda Ospedaliera San Camillo-Forlanini, Carlo Forlanini Hospital, Rome, Italy., Perdichizzi S; Management Department, University of Bologna, Bologna, Italy., Scarci M; Department of Cardiothoracic Surgery, Imperial College Healthcare NHS Trust, London, United Kingdom., Ricci A; Unit of Pulmonology, Sapienza University of Rome, San Andrea Hospital, Rome, Italy., Dello Iacono R; Unit of Pulmonology and Thoracic Endoscopy, Azienda Ospedaliera San Camillo-Forlanini., Lucantoni G; Carlo Forlanini Hospital, Rome, Italy., Galluccio G; Carlo Forlanini Hospital, Rome, Italy.
Jazyk:	angličtina
Zdroj:	Frontiers in surgery [Front Surg] 2022 Nov 23; Vol. 9, pp. 1049126. Date of Electronic Publication: 2022 Nov 23 (Print Publication: 2022).
DOI:	10.3389/fsurg.2022.1049126
Abstrakt:	Background: Post-intubation tracheal laceration (PITL) is a rare condition (0.005% of intubations). The treatment of choice has traditionally been surgical repair. Following our first report in 2010 of treatment protocol tailored to a risk-stratified morphological classification there is now clear evidence that conservative therapy represents the gold standard in the majority of patients. In this paper we aim to validate our risk-stratified treatment protocol through the largest ever reported series of patients. Methods: This retrospective analysis is based on a prospectively collected series (2003-2020) of 62 patients with PITL, staged and treated according to our revised morphological classification. Results: Fifty-five patients with Level I (#8), II (#36) and IIIA (#11) PITL were successfully treated conservatively. Six patients with Level IIIB injury and 1 patient with Level IV underwent a surgical repair of the trachea. No mortality was reported. Bronchoscopy confirmed complete healing in all patients by day 30. Statistical analysis showed age only to be a risk factor for PITL severity. Conclusions: Our previously proposed risk-stratified morphological classification has been validated as the major tool for defining the type of treatment in PITL. Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (© 2022 Cardillo, Ricciardi, Forcione, Carbone, Carleo, Di Martino, Jaus, Perdichizzi, Scarci, Ricci, Dello Iacono, Lucantoni and Galluccio.)
Databáze:	MEDLINE
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