SURGICAL OR CONSERVATIVE MANAGEMENT OF TRACHEOBRONCHIAL INJURY

Abstract

Background: Surgical intervention is considered as the radical traditional management of acute posttraumatic tracheobronchial lesions.The aim of the current study was to assess the effectiveness of conservative and surgical treatments for managing posttraumatic tracheobronchial injury management Methodology: This is a retrospective study of 27 patients, from January 2009 to December 2015, with posttraumatic tracheobronchial injuries who were managed in King Faisal Medical Complex (trauma hospital) and King Abdul-Aziz specialist hospital (tertiary hospital) in Taif city, Saudi Arabia. Results: Seventeen (63%) cases were treated conservatively, whereas the remaining 10 (37%) cases were treated surgically, the lesion was repaired with interrupted absorbable sutures. Conservative treatment consisted of endotracheal intubation, adequate ventilation with low tidal volumes, chest tube, prevention of pressure peaks as well as retention achieving a continuous control and Bronchoscopy follow-up. The overall survival rate within our series was 92.6% (25 patients). Two patients (7.4%) in our study died (one was treated surgically and the other conservatively) due to associated Polytrauma. Conclusions: In our experience, conservative treatment is a feasible, safe procedure with a mortality rate as low as that of surgical management, and therefore should be considered as an option in the management of tracheobronchial injuries.