Cardiothoracic Surgery |

Video-Assisted Endotracheal Suture for Tracheal Laceration After Intubation FREE TO VIEW

Andre Miotto; Luiz Eduardo Villaça Leão; Altair da Silva Costa; Pedro Augusto Antunes Honda; Caio Augusto Sterse Mata; Jose Ernesto Succi; João Aléssio Juliano Perfeito
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Escola Paulista de Medicina - Universidade Federal de Sao Paulo, Sao Paulo, Brazil

Chest. 2014;146(4_MeetingAbstracts):84A. doi:10.1378/chest.1994884
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SESSION TITLE: Postoperative ICU Issues Posters

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 29, 2014 at 01:30 PM - 02:30 PM

PURPOSE: The lacerations of the tracheal membranous wall often occur due to a tube insertion with a guide wire. It is a rare, however often lethal complication of this common procedure. The former technique for its treatment consisted in an open surgery that increased the morbidity in a high risk patient. We described, three years ago , a new minimally invasive technique for tracheal repair, using accessible video surgery materials. We now report the results of five patients operated by this technique.

METHODS: The patients were between 73 and 91 years old and underwent the procedure in the average of six hours after the trauma. The laceration was confirmed by bronchoscopy. The operating time was around two hours. We performed the suture inside the trachea, by a cervical incision, using a four mm video optic and video surgery instruments. In the end of the procedure, we placed a tracheostomy canulla.

RESULTS: One patient died in the second day after the surgery, due to her critical condition, however she had no sign of mediastinitis and reduction of the subcutaneous emphysema. The other patients had a satisfactory outcome after 30 days.

CONCLUSIONS: In conclusion, this technique is safe and feasible, and we had pleasant results in this series of five cases.

CLINICAL IMPLICATIONS: The minimally invasive tracheal suture is an ideal technique for the tracheal lacerations because it occurs in critical patients. Its low morbidity compared to the classic approach turns it in a mighty tool in the effort against this challenging situation.

DISCLOSURE: The following authors have nothing to disclose: Andre Miotto, Luiz Eduardo Villaça Leão, Altair da Silva Costa, Pedro Augusto Antunes Honda, Caio Augusto Sterse Mata, Jose Ernesto Succi, João Aléssio Juliano Perfeito

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