Diagnostic and therapeutic approach to post-traumatic tracheobronchial injuries
1Department of Thoracic Surgery, San Raffaele Scientiﬁc Institute, 60 - 20132 Milan, Italy
2School of Medicine, Vita-salute San Raffaele University, 60 - 20132 Milan, Italy
DOI: 10.22514/sv.2021.015 Vol.17,Issue 2,March 2021 pp.10-19
Published: 08 March 2021
Post-traumatic tracheobronchial lesions are associated with high mortality unless adequately diagnosed and treated. They may be caused by blunt and penetrating trauma, although iatrogenic lesions are also increasingly observed. An early and accurate diagnosis significantly impacts the results of treatment. Radiological assessment with computed tomography is highly accurate, but bronchoscopy remains the gold standard technique in the diagnosis of airway trauma and plays an important role in determining the therapeutic approach. For a long time, surgery has been considered the treatment of choice for post-traumatic airway lesions, but recent reports have shown that favourable results may also be obtained with a conservative approach, especially in the treatment of iatrogenic lesions. The indication for a conservative or surgical treatment has to be defined on the basis of a thorough clinical, radiological, and endoscopic assessment. Specific issues concerning airway management in the emergency setting and during surgical treatment must also be addressed. A multidisciplinary approach in a center with specific experience in the treatment of airway lesions is of utmost importance to obtain favourable results.
Airway; Trauma; Surgery; Anesthesia; Conservative
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