The Surgical Outcome for Patients with Tracheobronchial Injury in Blunt Group and Penetrating Group

Kim, Chang Wan; Hwang, Jung Joo; Cho, Hyun Min; Cho, Jeong Su; I, Ho Seok; Kim, Yeong Dae; Kim, Do Hyung

Abstract

PURPOSE
Tracheobronchial injuries caused by trauma are rare, but can be life threatening. The objective of this study was to evaluate the surgical outcome for patients with tracheobronchial injuries and to determine the difference, if any, between the outcomes for patients with penetrating trauma and those for patients with blunt trauma.
METHODS
From January 2010 to June 2015, 40 patients underwent tracheobronchial repair surgery due to trauma. We excluded 14 patients with iatrogenic injuries, and divided the remaining 26 into two groups.
RESULTS
In the blunt trauma group, injury mechanisms were motor vehicle accident (9 cases), free falls (3 cases), flat falls (1 case) and mechanical injury (1 case). In the penetrating trauma group, injury mechanisms were stab wounds (10 cases), a gunshot wound (1 case) and a stab wound caused by metal pieces (1 case). The mean RTS (Revised Trauma Score) was 6.89±1.59 (range: 2.40-7.84) and the mean ISS (Injury Severity Score) was 24.36±7.16 (range: 11-34) in the blunt group; the mean RTS was 7.56±0.41 (range: 7.11-7.84), and the mean ISS was 13±5.26 (range: 9-25) in the penetrating trauma group. In the blunt trauma group, 9 primary repairs, 1 resection with end-end anastomosis, 2 lobectomies, 1 sleeve bronchial resection and 1 pneumonectomy were performed. In the penetrating trauma group, 10 primary repairs and 2 resections with end-end anastomosis were performed. Complications associated with surgery were found in one patient in the blunt trauma group, and one patient in the penetrating trauma group. No mortalities occurred in either groups.
CONCLUSION
Surgical management of a traumatic tracheobronchial injury is a safe procedure for both patients with a penetrating trauma and those with a blunt trauma.