Post-intubation tracheal rupture. A report on ten cases.

OBJECTIVE: We wanted to evaluate the role of surgical and conservative therapy in the treatment of post-intubation tracheal rupture. METHODS: A retrospective study was performed on 10 consecutive patients (9 women and 1 man) treated over a 7-year period. RESULTS: A tracheal rupture following double-lumen intubation was recognized and repaired at the time of lobectomy for lung cancer. Five patients with rents ranging from 2.5 cm to 5 cm underwent primary repair through a cervical collar incision (n = 3) or right posterolateral thoracotomy (n = 2). Three patients had small tears (about 1 cm in length) and were treated conservatively. Tracheostomy was performed in one patient with a 1.5-cm long laceration and extensive subcutaneous emphysema. Results were uniformly good. CONCLUSIONS: Early surgical repair is the preferred treatment for most patients with post-intubation tracheal ruptures. Conservative treatment may be a viable alternative for patients with small rents, in the absence of gross air leak, or for those judged unsuitable for surgery. The role of tracheostomy is limited by its potential for late sequelae.