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        "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p class="elsevierStyleSimplePara elsevierViewall">TO describe the medical and surgical management of noniatrogenic traumatic tracheobronchial injuries&#46;</p> <span class="elsevierStyleSectionTitle">Patients and methods</span><p class="elsevierStyleSimplePara elsevierViewall">From January 1993 to July 2004&#44; 15 cases of traumatic tracheobronchial injury were treated in our department&#46; The diagnosis was established by bronchoscopy and a computed tomography chest scan was performed on all patients&#46; Surgical treatment was selected for patients with unstable vital signs&#44; an open tracheal wound&#44; associated esophageal lesions&#44; progression of subcutaneous or mediastinal emphysema&#44; mediastinitis or suspicious mediastinal secretions on imaging tests&#44; or difficulties with mechanical ventilation due to the traumatic tracheobronchial injury&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">The mean &#40;SD&#41; age of the patients was 35&#46;5 &#40;18&#46;9&#41; years and 12 &#40;80&#37;&#41; were male&#46; Of the 15 cases&#44; 13 &#40;86&#46;7&#37;&#41; had penetrating trauma and 2 &#40;13&#46;3&#37;&#41; blunt trauma&#46; The most common location of the injury was in the bronchi &#40;9 cases&#59; 60&#37;&#41;&#44; followed by the cervical trachea &#40;4 cases&#59; 26&#46;6&#37;&#41;&#44; followed by both the thoracic trachea and bronchi &#40;2 cases&#59; 13&#46;4&#37;&#41;&#46; The most common initial symptom was subcutaneous emphysema&#44; which presented in 11 &#40;73&#46;3&#37;&#41; patients&#46; Chest &#40;12 cases&#59; 86&#46;7&#37;&#41; and orthopedic injuries &#40;9 cases&#59; 60&#37;&#41; were the most common associated injuries&#46; Surgery was the treatment of choice in 11 &#40;73&#46;3&#37;&#41; cases and conservative medical treatment in 4 &#40;26&#46;7&#37;&#41;&#46; An irreversible brain injury caused the death of 1 patient receiving conservative treatment&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">Tracheobronchial injuries may be treated conservatively if they meet strict selection criteria&#46; Size and location should not be used as selection criteria for surgical treatment&#46;</p>"
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        "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p class="elsevierStyleSimplePara elsevierViewall">Describir el manejo m&#233;dico-quir&#250;rgico de las lesiones traqueobronquiales traum&#225;ticas no iatrog&#233;nicas&#46;</p> <span class="elsevierStyleSectionTitle">Patientes y m&#233;todos</span><p class="elsevierStyleSimplePara elsevierViewall">De enero de 1993 a julio de 2004 se registraron en nuestro servicio 15 casos de lesiones traqueobronquiales traum&#225;ticas&#46; En todos los pacientes el diagn&#243;stico se estableci&#243; por broncoscopia y a todos se le realiz&#243; una tomograf&#237;a computarizada de t&#243;rax&#46; Se eligi&#243; tratamiento quir&#250;rgico cuando hab&#237;a inestabilidad vital del paciente&#44; herida traqueal abierta&#44; lesiones esof&#225;gicas asociadas&#44; progresi&#243;n de enfisema subcut&#225;neo o mediast&#237;nico&#44; mediastinitis o colecciones mediast&#237;nicas sospechosas en pruebas de imagen o dificultades en la ventilaci&#243;n mec&#225;nica por la lesi&#243;n tra-queobronquial traum&#225;tica&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">La edad media &#40;&#177; desviaci&#243;n est&#225;ndar&#41; de los pacientes fue de 35&#44;5 &#177; 18&#44;9 a&#241;os y 12 &#40;80&#37;&#41; eran varones&#46; Se registraron 13 traumatismos cerrados &#40;86&#44;7&#37;&#41; y 2 abiertos &#40;13&#44;3&#37;&#41;&#46; La localizaci&#243;n m&#225;s frecuente de la lesi&#243;n fue bronquial &#40;9 casos&#59; 60&#37;&#41;&#44; seguida de tr&#225;quea cervical &#40;4 casos&#59; 26&#44;6&#37;&#41; y tr&#225;quea toracicobronquial &#40;2 casos&#59; 13&#44;4&#37;&#41;&#46; El s&#237;ntoma inicial m&#225;s frecuente fue el enfisema subcut&#225;neo&#44; que presentaron 11 pacientes &#40;73&#44;3&#37;&#41;&#46; Las lesiones asociadas m&#225;s frecuentes fueron tor&#225;cicas&#44; con 12 casos &#40;86&#44;7&#37;&#41;&#44; seguidas de ortop&#233;dicas&#44; con 9 &#40;60&#37;&#41;&#46; El tratamiento de elecci&#243;n fue quir&#250;rgico en 11 casos &#40;73&#44;3&#37;&#41; y m&#233;dico con-servador en 4 &#40;26&#44;7&#37;&#41;&#46; Falleci&#243; una paciente tratada de forma conservadora por lesi&#243;n cerebral irreversible&#46;</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">Las lesiones traqueobronquiales pueden tratarse de forma conservadora si cumplen criterios estric-tos de selecci&#243;n&#46; El tama&#241;o o la localizaci&#243;n no debe ser un criterio para la elecci&#243;n del tratamiento quir&#250;rgico&#46;</p>"
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Original Articles
Medical and Surgical Management of Noniatrogenic Traumatic Tracheobronchial Injuries
A. Gómez-Caro Andrésa,
Corresponding author
abelitov@yahoo.es
ablgomez@hotmail.com

Correspondence: Dr. A. Gómez-Caro Andrés. Servicio de Cirugía Torácica. Hospital Universitario 12 de Octubre. Ctra. de Andalucía, km 5,400. 28041 Madrid. España
, P. Ausín Herrerob, F.J. Moradiellos Díeza, V. Díaz-Hellína, E. Larrú Cabreroa, J.A. Pérez Antóna, J.L. Martín de Nicolása
a Servicio de Cirugía Torácica, Hospital Universitario 12 de Octubre, Madrid, Spain
b Servicio de Neumología, Hospital Universitario 12 de Octubre, Madrid, Spain
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        "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p class="elsevierStyleSimplePara elsevierViewall">TO describe the medical and surgical management of noniatrogenic traumatic tracheobronchial injuries&#46;</p> <span class="elsevierStyleSectionTitle">Patients and methods</span><p class="elsevierStyleSimplePara elsevierViewall">From January 1993 to July 2004&#44; 15 cases of traumatic tracheobronchial injury were treated in our department&#46; The diagnosis was established by bronchoscopy and a computed tomography chest scan was performed on all patients&#46; Surgical treatment was selected for patients with unstable vital signs&#44; an open tracheal wound&#44; associated esophageal lesions&#44; progression of subcutaneous or mediastinal emphysema&#44; mediastinitis or suspicious mediastinal secretions on imaging tests&#44; or difficulties with mechanical ventilation due to the traumatic tracheobronchial injury&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">The mean &#40;SD&#41; age of the patients was 35&#46;5 &#40;18&#46;9&#41; years and 12 &#40;80&#37;&#41; were male&#46; Of the 15 cases&#44; 13 &#40;86&#46;7&#37;&#41; had penetrating trauma and 2 &#40;13&#46;3&#37;&#41; blunt trauma&#46; The most common location of the injury was in the bronchi &#40;9 cases&#59; 60&#37;&#41;&#44; followed by the cervical trachea &#40;4 cases&#59; 26&#46;6&#37;&#41;&#44; followed by both the thoracic trachea and bronchi &#40;2 cases&#59; 13&#46;4&#37;&#41;&#46; The most common initial symptom was subcutaneous emphysema&#44; which presented in 11 &#40;73&#46;3&#37;&#41; patients&#46; Chest &#40;12 cases&#59; 86&#46;7&#37;&#41; and orthopedic injuries &#40;9 cases&#59; 60&#37;&#41; were the most common associated injuries&#46; Surgery was the treatment of choice in 11 &#40;73&#46;3&#37;&#41; cases and conservative medical treatment in 4 &#40;26&#46;7&#37;&#41;&#46; An irreversible brain injury caused the death of 1 patient receiving conservative treatment&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">Tracheobronchial injuries may be treated conservatively if they meet strict selection criteria&#46; Size and location should not be used as selection criteria for surgical treatment&#46;</p>"
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        "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p class="elsevierStyleSimplePara elsevierViewall">Describir el manejo m&#233;dico-quir&#250;rgico de las lesiones traqueobronquiales traum&#225;ticas no iatrog&#233;nicas&#46;</p> <span class="elsevierStyleSectionTitle">Patientes y m&#233;todos</span><p class="elsevierStyleSimplePara elsevierViewall">De enero de 1993 a julio de 2004 se registraron en nuestro servicio 15 casos de lesiones traqueobronquiales traum&#225;ticas&#46; En todos los pacientes el diagn&#243;stico se estableci&#243; por broncoscopia y a todos se le realiz&#243; una tomograf&#237;a computarizada de t&#243;rax&#46; Se eligi&#243; tratamiento quir&#250;rgico cuando hab&#237;a inestabilidad vital del paciente&#44; herida traqueal abierta&#44; lesiones esof&#225;gicas asociadas&#44; progresi&#243;n de enfisema subcut&#225;neo o mediast&#237;nico&#44; mediastinitis o colecciones mediast&#237;nicas sospechosas en pruebas de imagen o dificultades en la ventilaci&#243;n mec&#225;nica por la lesi&#243;n tra-queobronquial traum&#225;tica&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">La edad media &#40;&#177; desviaci&#243;n est&#225;ndar&#41; de los pacientes fue de 35&#44;5 &#177; 18&#44;9 a&#241;os y 12 &#40;80&#37;&#41; eran varones&#46; Se registraron 13 traumatismos cerrados &#40;86&#44;7&#37;&#41; y 2 abiertos &#40;13&#44;3&#37;&#41;&#46; La localizaci&#243;n m&#225;s frecuente de la lesi&#243;n fue bronquial &#40;9 casos&#59; 60&#37;&#41;&#44; seguida de tr&#225;quea cervical &#40;4 casos&#59; 26&#44;6&#37;&#41; y tr&#225;quea toracicobronquial &#40;2 casos&#59; 13&#44;4&#37;&#41;&#46; El s&#237;ntoma inicial m&#225;s frecuente fue el enfisema subcut&#225;neo&#44; que presentaron 11 pacientes &#40;73&#44;3&#37;&#41;&#46; Las lesiones asociadas m&#225;s frecuentes fueron tor&#225;cicas&#44; con 12 casos &#40;86&#44;7&#37;&#41;&#44; seguidas de ortop&#233;dicas&#44; con 9 &#40;60&#37;&#41;&#46; El tratamiento de elecci&#243;n fue quir&#250;rgico en 11 casos &#40;73&#44;3&#37;&#41; y m&#233;dico con-servador en 4 &#40;26&#44;7&#37;&#41;&#46; Falleci&#243; una paciente tratada de forma conservadora por lesi&#243;n cerebral irreversible&#46;</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">Las lesiones traqueobronquiales pueden tratarse de forma conservadora si cumplen criterios estric-tos de selecci&#243;n&#46; El tama&#241;o o la localizaci&#243;n no debe ser un criterio para la elecci&#243;n del tratamiento quir&#250;rgico&#46;</p>"
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ISSN: 15792129
Original language: English
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2016 August 16 4 20
2016 July 7 0 7
2016 March 2 0 2
2015 December 2 0 2
2015 October 91 1 92
2015 September 69 13 82
2015 August 57 6 63
2015 July 123 14 137
2015 June 53 8 61
2015 May 65 10 75
2015 April 54 9 63
2015 March 70 9 79
2015 February 64 5 69
2015 January 62 6 68
2014 December 72 14 86
2014 November 76 6 82
2014 October 82 15 97
2014 September 73 14 87
2014 August 67 12 79
2014 July 63 11 74
2014 June 68 12 80
2014 May 68 10 78
2014 April 55 5 60
2014 March 89 10 99
2014 February 69 10 79
2014 January 73 14 87
2013 December 52 9 61
2013 November 57 9 66
2013 October 58 16 74
2013 September 48 14 62
2013 August 72 12 84
2013 July 58 20 78
2013 June 45 20 65
2013 May 51 14 65
2013 April 23 8 31
2013 March 7 3 10
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