array:23 [
  "pii" => "S1579212906602188"
  "issn" => "15792129"
  "doi" => "10.1016/S1579-2129(06)60218-8"
  "estado" => "S300"
  "fechaPublicacion" => "2005-05-01"
  "aid" => "60218"
  "copyright" => "Sociedad Española de Neumología y Cirugía Torácica (SEPAR)"
  "copyrightAnyo" => "2005"
  "documento" => "article"
  "crossmark" => 0
  "subdocumento" => "fla"
  "cita" => "Arch Bronconeumol. 2005;41:249-54"
  "abierto" => array:3 [
    "ES" => false
    "ES2" => false
    "LATM" => false
  ]
  "gratuito" => false
  "lecturas" => array:2 [
    "total" => 3595
    "formatos" => array:3 [
      "EPUB" => 91
      "HTML" => 2569
      "PDF" => 935
    ]
  ]
  "itemSiguiente" => array:18 [
    "pii" => "S157921290660219X"
    "issn" => "15792129"
    "doi" => "10.1016/S1579-2129(06)60219-X"
    "estado" => "S300"
    "fechaPublicacion" => "2005-05-01"
    "aid" => "60219"
    "copyright" => "Sociedad Española de Neumología y Cirugía Torácica (SEPAR)"
    "documento" => "article"
    "crossmark" => 0
    "subdocumento" => "fla"
    "cita" => "Arch Bronconeumol. 2005;41:255-9"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:2 [
      "total" => 2388
      "formatos" => array:3 [
        "EPUB" => 89
        "HTML" => 1681
        "PDF" => 618
      ]
    ]
    "en" => array:10 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Original Articles</span>"
      "titulo" => "Lung Transplant Therapy for Suppurative Diseases"
      "tienePdf" => "en"
      "tieneTextoCompleto" => 0
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "es"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "255"
          "paginaFinal" => "259"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "es" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "A&#46; de Pablo, S&#46; L&#243;pez, P&#46; Ussetti, M&#46;C&#46; Carre&#241;o, R&#46; Laporta, C&#46; L&#243;pez Garc&#237;a-Gallo, M&#46;J&#46; Ferreiro"
          "autores" => array:7 [
            0 => array:3 [
              "preGrado" => "Dr&#46;"
              "nombre" => "A&#46;"
              "apellidos" => "de Pablo"
            ]
            1 => array:2 [
              "nombre" => "S&#46;"
              "apellidos" => "L&#243;pez"
            ]
            2 => array:2 [
              "nombre" => "P&#46;"
              "apellidos" => "Ussetti"
            ]
            3 => array:2 [
              "nombre" => "M&#46;C&#46;"
              "apellidos" => "Carre&#241;o"
            ]
            4 => array:2 [
              "nombre" => "R&#46;"
              "apellidos" => "Laporta"
            ]
            5 => array:2 [
              "nombre" => "C&#46;"
              "apellidos" => "L&#243;pez Garc&#237;a-Gallo"
            ]
            6 => array:2 [
              "nombre" => "M&#46;J&#46;"
              "apellidos" => "Ferreiro"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S157921290660219X?idApp=UINPBA00003Z"
    "url" => "/15792129/0000004100000005/v1_201305150216/S157921290660219X/v1_201305150216/en/main.assets"
  ]
  "itemAnterior" => array:18 [
    "pii" => "S1579212906602176"
    "issn" => "15792129"
    "doi" => "10.1016/S1579-2129(06)60217-6"
    "estado" => "S300"
    "fechaPublicacion" => "2005-05-01"
    "aid" => "60217"
    "copyright" => "Sociedad Espa&#241;ola de Neumolog&#237;a y Cirug&#237;a Tor&#225;cica &#40;SEPAR&#41;"
    "documento" => "article"
    "crossmark" => 0
    "subdocumento" => "fla"
    "cita" => "Arch Bronconeumol. 2005;41:242-8"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:2 [
      "total" => 2904
      "formatos" => array:3 [
        "EPUB" => 99
        "HTML" => 1815
        "PDF" => 990
      ]
    ]
    "en" => array:10 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Original Articles</span>"
      "titulo" => "Cost-Effectiveness Analysis of Tiotropium Compared to Ipratropium and Salmeterol"
      "tienePdf" => "en"
      "tieneTextoCompleto" => 0
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "es"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "242"
          "paginaFinal" => "248"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "es" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "A&#46;J&#46; Garc&#237;a Ruiz, F&#46; Leiva Fern&#225;ndez, F&#46; Martos Crespo"
          "autores" => array:3 [
            0 => array:3 [
              "preGrado" => "Prof&#46;"
              "nombre" => "A&#46;J&#46;"
              "apellidos" => "Garc&#237;a Ruiz"
            ]
            1 => array:2 [
              "nombre" => "F&#46;"
              "apellidos" => "Leiva Fern&#225;ndez"
            ]
            2 => array:2 [
              "nombre" => "F&#46;"
              "apellidos" => "Martos Crespo"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212906602176?idApp=UINPBA00003Z"
    "url" => "/15792129/0000004100000005/v1_201305150216/S1579212906602176/v1_201305150216/en/main.assets"
  ]
  "en" => array:14 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Original Articles</span>"
    "titulo" => "Medical and Surgical Management of Noniatrogenic Traumatic Tracheobronchial Injuries"
    "tieneTextoCompleto" => 0
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "249"
        "paginaFinal" => "254"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "A&#46; G&#243;mez-Caro Andr&#233;s, P&#46; Aus&#237;n Herrero, F&#46;J&#46; Moradiellos D&#237;ez, V&#46; D&#237;az-Hell&#237;n, E&#46; Larr&#250; Cabrero, J&#46;A&#46; P&#233;rez Ant&#243;n, J&#46;L&#46; Mart&#237;n de Nicol&#225;s"
        "autores" => array:7 [
          0 => array:5 [
            "preGrado" => "Dr&#46;"
            "nombre" => "A&#46;"
            "apellidos" => "G&#243;mez-Caro Andr&#233;s"
            "email" => array:2 [
              0 => "abelitov&#64;yahoo&#46;es"
              1 => "ablgomez&#64;hotmail&#46;com"
            ]
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff1"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor1"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "P&#46;"
            "apellidos" => "Aus&#237;n Herrero"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff2"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "F&#46;J&#46;"
            "apellidos" => "Moradiellos D&#237;ez"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff1"
              ]
            ]
          ]
          3 => array:3 [
            "nombre" => "V&#46;"
            "apellidos" => "D&#237;az-Hell&#237;n"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff1"
              ]
            ]
          ]
          4 => array:3 [
            "nombre" => "E&#46;"
            "apellidos" => "Larr&#250; Cabrero"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff1"
              ]
            ]
          ]
          5 => array:3 [
            "nombre" => "J&#46;A&#46;"
            "apellidos" => "P&#233;rez Ant&#243;n"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff1"
              ]
            ]
          ]
          6 => array:3 [
            "nombre" => "J&#46;L&#46;"
            "apellidos" => "Mart&#237;n de Nicol&#225;s"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff1"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:2 [
          0 => array:3 [
            "entidad" => "Servicio de Cirug&#237;a Tor&#225;cica&#44; Hospital Universitario 12 de Octubre&#44; Madrid&#44; Spain"
            "etiqueta" => "<span class="elsevierStyleSup">a</span>"
            "identificador" => "aff1"
          ]
          1 => array:3 [
            "entidad" => "Servicio de Neumolog&#237;a&#44; Hospital Universitario 12 de Octubre&#44; Madrid&#44; Spain"
            "etiqueta" => "<span class="elsevierStyleSup">b</span>"
            "identificador" => "aff2"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor1"
            "etiqueta" => "&#42;"
            "correspondencia" => "Correspondence&#58; Dr&#46; A&#46; G&#243;mez-Caro Andr&#233;s&#46; Servicio de Cirug&#237;a Tor&#225;cica&#46; Hospital Universitario 12 de Octubre&#46; Ctra&#46; de Andaluc&#237;a&#44; km 5&#44;400&#46; 28041 Madrid&#46; Espa&#241;a"
          ]
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2004-08-25"
    "fechaAceptado" => "2004-10-26"
    "PalabrasClave" => array:2 [
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Key Words"
          "identificador" => "xpalclavsec154061"
          "palabras" => array:6 [
            0 => "Tracheobronchial injuries"
            1 => "Trauma"
            2 => "Bronchial rupture"
            3 => "Subcutaneous emphysema"
            4 => "Bronchoscopy"
            5 => "Thoracotomy"
          ]
        ]
      ]
      "es" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec154062"
          "palabras" => array:6 [
            0 => "Lesiones traqueobronquiales"
            1 => "Traumatismo"
            2 => "Rotura bronquial"
            3 => "Enfisema subcut&#225;neo"
            4 => "Broncoscopia"
            5 => "Toracotom&#237;a"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "en" => array:1 [
        "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>"
      ]
      "es" => array:1 [
        "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>"
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "REFERENCES"
      "seccion" => array:1 [
        0 => array:1 [
          "bibliografiaReferencia" => array:23 [
            0 => array:3 [
              "identificador" => "bib1"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Iatrogenic ruptures of the tracheobronchial tree"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "H Kaloud"
                            1 => "FM Smolle-Juettner"
                            2 => "G Prause"
                            3 => "WF List"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Chest"
                        "fecha" => "1997"
                        "volumen" => "112"
                        "paginaInicial" => "774"
                        "paginaFinal" => "778"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9315814"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib2"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Iatrogenic ruptures of the tracheobronchial tree"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "HS Hofmann"
                            1 => "G Rettig"
                            2 => "J Radke"
                            3 => "H Neef"
                            4 => "RE Silber"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur J Cardiothorac Surg"
                        "fecha" => "2002"
                        "volumen" => "21"
                        "paginaInicial" => "649"
                        "paginaFinal" => "652"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11932162"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib3"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Early diagnosis of traumatic rupture of the bronchus"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "JF Burke"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "JAMA"
                        "fecha" => "1962"
                        "volumen" => "181"
                        "paginaInicial" => "682"
                        "paginaFinal" => "686"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/13874883"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib4"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Management of tracheobronchial injuries following blunt and penetrating trauma"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "J Huh"
                            1 => "JC Milliken"
                            2 => "JC Chen"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Am Surg"
                        "fecha" => "1997"
                        "volumen" => "63"
                        "paginaInicial" => "896"
                        "paginaFinal" => "899"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9322668"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib5"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Tracheobronchial rupture&#58; a considerable risk for young teenagers"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M Kaptanoglu"
                            1 => "K Dogan"
                            2 => "A Nadir"
                            3 => "U Gonlugur"
                            4 => "I Akkurt"
                            5 => "Z Seyfikli"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Int J Pediatr Otorhinolaryngol"
                        "fecha" => "2002"
                        "volumen" => "62"
                        "paginaInicial" => "123"
                        "paginaFinal" => "128"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11788144"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib6"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Surgical treatment of posttraumatic tracheobronchial injuries&#58; 14-year experience"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "AE Balci"
                            1 => "N Eren"
                            2 => "S Eren"
                            3 => "R Ulku"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur J Cardiothorac Surg"
                        "fecha" => "2002"
                        "volumen" => "22"
                        "paginaInicial" => "984"
                        "paginaFinal" => "989"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12467824"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib7"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Management of major tracheobronchial injuries&#58; a 28-year experience"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "MM Rossbach"
                            1 => "SB Johnson"
                            2 => "MA G&#243;mez"
                            3 => "EY Sako"
                            4 => "OL Miller"
                            5 => "JH Calhoon"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Thorac Surg"
                        "fecha" => "1998"
                        "volumen" => "65"
                        "paginaInicial" => "182"
                        "paginaFinal" => "186"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9456114"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib8"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Extrinsic civilian trauma to the larynx and cervical trachea&#8212;important predictors of long-term morbidity"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "PB Angood"
                            1 => "EL Attia"
                            2 => "RA Brown"
                            3 => "DS Mulder"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Trauma"
                        "fecha" => "1986"
                        "volumen" => "26"
                        "paginaInicial" => "869"
                        "paginaFinal" => "873"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3772995"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib9"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Blunt tracheobronchial injuries&#58; treatment and outcomes"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "AC Kiser"
                            1 => "SM O&#39;Brien"
                            2 => "FC Detterbeck"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Thorac Surg"
                        "fecha" => "2001"
                        "volumen" => "71"
                        "paginaInicial" => "2059"
                        "paginaFinal" => "2065"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11426809"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib10"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Post-intubation tracheal rupture&#46; A report on ten cases"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "P Borasio"
                            1 => "F Ardissone"
                            2 => "G Chiampo"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur J Cardiothorac Surg"
                        "fecha" => "1997"
                        "volumen" => "12"
                        "paginaInicial" => "98"
                        "paginaFinal" => "100"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9262088"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib11"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Acute injuries of the trachea and major bronchi&#58; importance of early diagnosis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "DC Cassada"
                            1 => "MP Munyikwa"
                            2 => "MP Moniz"
                            3 => "RA Dieter Jr"
                            4 => "GF Schuchmann"
                            5 => "BL Enderson"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Thorac Surg"
                        "fecha" => "2000"
                        "volumen" => "69"
                        "paginaInicial" => "1563"
                        "paginaFinal" => "1567"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10881842"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib12"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Acute major airway injuries&#58; clinical features and management"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "A Mussi"
                            1 => "MC Ambrogi"
                            2 => "A Ribechini"
                            3 => "M Lucchi"
                            4 => "F Menoni"
                            5 => "CA Angeletti"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur J Cardiothorac Surg"
                        "fecha" => "2001"
                        "volumen" => "20"
                        "paginaInicial" => "46"
                        "paginaFinal" => "51"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11423273"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib13"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Tracheal rupture and the creation of a false passage after emergency intubation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "D Sternfeld"
                            1 => "S Wright"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1067/mem.2003.278"
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Emerg Med"
                        "fecha" => "2003"
                        "volumen" => "42"
                        "paginaInicial" => "88"
                        "paginaFinal" => "92"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12827127"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib14"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Management of postintubation membranous tracheal rupture"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "P Carbognani"
                            1 => "A Bobbio"
                            2 => "L Cattelani"
                            3 => "E Internullo"
                            4 => "D Caporale"
                            5 => "M Rusca"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/S0003-4975(03)01344-4"
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Thorac Surg"
                        "fecha" => "2004"
                        "volumen" => "77"
                        "paginaInicial" => "406"
                        "paginaFinal" => "409"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14759406"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib15"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Conservative treatment for postintubation tracheobronchial rupture"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "J Jougon"
                            1 => "M Ballester"
                            2 => "E Choukroun"
                            3 => "J Dubrez"
                            4 => "G Reboul"
                            5 => "JF Velly"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Thorac Surg"
                        "fecha" => "2000"
                        "volumen" => "69"
                        "paginaInicial" => "216"
                        "paginaFinal" => "220"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10654516"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib16"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Nonoperative management of tracheal laceration during endotracheal intubation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "HM Ross"
                            1 => "FJ Grant"
                            2 => "RS Wilson"
                            3 => "ME Burt"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Thorac Surg"
                        "fecha" => "1997"
                        "volumen" => "63"
                        "paginaInicial" => "240"
                        "paginaFinal" => "242"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8993280"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib17"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Tratamiento de rupturas traqueobronquiales&#58; una revisi&#243;n de 6 casos"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J Zapatero"
                            1 => "J Flandes"
                            2 => "R Penalver"
                            3 => "L Madrigal"
                            4 => "J Lago"
                            5 => "SD Reboiras"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Bronconeumol"
                        "fecha" => "1996"
                        "volumen" => "32"
                        "paginaInicial" => "222"
                        "paginaFinal" => "224"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8696645"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib18"
              "etiqueta" => "18"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Tratamiento conservador de 2 lesiones traqueales secundarias a intubaci&#243;n an&#233;stesica"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "LJ Buitrago"
                            1 => "L Molins"
                            2 => "JE Boada"
                            3 => "JJ Sopena"
                            4 => "G Vidal"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Bronconeumol"
                        "fecha" => "1997"
                        "volumen" => "33"
                        "paginaInicial" => "151"
                        "paginaFinal" => "153"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9181990"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib19"
              "etiqueta" => "19"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Management of major tracheobronchial injuries&#58; a 28-year experience"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "MM Rossbach"
                            1 => "SB Johnson"
                            2 => "MA G&#243;mez"
                            3 => "EY Sako"
                            4 => "OL Miller"
                            5 => "JH Calhoon"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Thorac Surg"
                        "fecha" => "1998"
                        "volumen" => "65"
                        "paginaInicial" => "182"
                        "paginaFinal" => "186"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9456114"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib20"
              "etiqueta" => "20"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Indications for surgery in tracheobronchial ruptures"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S Gabor"
                            1 => "H Renner"
                            2 => "H Pinter"
                            3 => "O Sankin"
                            4 => "A Maier"
                            5 => "F Tomaselli"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur J Cardiothorac Surg"
                        "fecha" => "2001"
                        "volumen" => "20"
                        "paginaInicial" => "399"
                        "paginaFinal" => "404"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11463564"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib21"
              "etiqueta" => "21"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Outcome of tracheobronchial injuries&#58; a long-term perspective"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "JD Richardson"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/01.TA.0000108631.72315.78"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Trauma"
                        "fecha" => "2004"
                        "volumen" => "56"
                        "paginaInicial" => "30"
                        "paginaFinal" => "36"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14749562"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib22"
              "etiqueta" => "22"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Traumatic and iatrogenic lesions of the trachea and bronchi"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "A Tcherveniakov"
                            1 => "P Tchalakov"
                            2 => "P Tcherveniakov"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur J Cardiothorac Surg"
                        "fecha" => "2001"
                        "volumen" => "19"
                        "paginaInicial" => "19"
                        "paginaFinal" => "24"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11163555"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib23"
              "etiqueta" => "23"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Transcervical repair of distal membranous tracheal laceration"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "T Angelillo-Mackinlay"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Thorac Surg"
                        "fecha" => "1995"
                        "volumen" => "59"
                        "paginaInicial" => "531"
                        "paginaFinal" => "532"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7847986"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/15792129/0000004100000005/v1_201305150216/S1579212906602188/v1_201305150216/en/main.assets"
  "Apartado" => null
  "PDF" => "https://static.elsevier.es/multimedia/15792129/0000004100000005/v1_201305150216/S1579212906602188/v1_201305150216/en/main.pdf?idApp=UINPBA00003Z&text.app=https://archbronconeumol.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212906602188?idApp=UINPBA00003Z"
]
Share
Journal Information
Vol. 41. Issue 5.
Pages 249-254 (May 2005)
Share
Share
Download PDF
More article options
Vol. 41. Issue 5.
Pages 249-254 (May 2005)
Original Articles
Full text access
Medical and Surgical Management of Noniatrogenic Traumatic Tracheobronchial Injuries
Visits
5530
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
This item has received
Article information
Abstract
Bibliography
Download PDF
Statistics
Objective

TO describe the medical and surgical management of noniatrogenic traumatic tracheobronchial injuries.

Patients and methods

From January 1993 to July 2004, 15 cases of traumatic tracheobronchial injury were treated in our department. The diagnosis was established by bronchoscopy and a computed tomography chest scan was performed on all patients. Surgical treatment was selected for patients with unstable vital signs, an open tracheal wound, associated esophageal lesions, progression of subcutaneous or mediastinal emphysema, mediastinitis or suspicious mediastinal secretions on imaging tests, or difficulties with mechanical ventilation due to the traumatic tracheobronchial injury.

Results

The mean (SD) age of the patients was 35.5 (18.9) years and 12 (80%) were male. Of the 15 cases, 13 (86.7%) had penetrating trauma and 2 (13.3%) blunt trauma. The most common location of the injury was in the bronchi (9 cases; 60%), followed by the cervical trachea (4 cases; 26.6%), followed by both the thoracic trachea and bronchi (2 cases; 13.4%). The most common initial symptom was subcutaneous emphysema, which presented in 11 (73.3%) patients. Chest (12 cases; 86.7%) and orthopedic injuries (9 cases; 60%) were the most common associated injuries. Surgery was the treatment of choice in 11 (73.3%) cases and conservative medical treatment in 4 (26.7%). An irreversible brain injury caused the death of 1 patient receiving conservative treatment.

Conclusions

Tracheobronchial injuries may be treated conservatively if they meet strict selection criteria. Size and location should not be used as selection criteria for surgical treatment.

Key Words:
Tracheobronchial injuries
Trauma
Bronchial rupture
Subcutaneous emphysema
Bronchoscopy
Thoracotomy
Objetivo

Describir el manejo médico-quirúrgico de las lesiones traqueobronquiales traumáticas no iatrogénicas.

Patientes y métodos

De enero de 1993 a julio de 2004 se registraron en nuestro servicio 15 casos de lesiones traqueobronquiales traumáticas. En todos los pacientes el diagnóstico se estableció por broncoscopia y a todos se le realizó una tomografía computarizada de tórax. Se eligió tratamiento quirúrgico cuando había inestabilidad vital del paciente, herida traqueal abierta, lesiones esofágicas asociadas, progresión de enfisema subcutáneo o mediastínico, mediastinitis o colecciones mediastínicas sospechosas en pruebas de imagen o dificultades en la ventilación mecánica por la lesión tra-queobronquial traumática.

Resultados

La edad media (± desviación estándar) de los pacientes fue de 35,5 ± 18,9 años y 12 (80%) eran varones. Se registraron 13 traumatismos cerrados (86,7%) y 2 abiertos (13,3%). La localización más frecuente de la lesión fue bronquial (9 casos; 60%), seguida de tráquea cervical (4 casos; 26,6%) y tráquea toracicobronquial (2 casos; 13,4%). El síntoma inicial más frecuente fue el enfisema subcutáneo, que presentaron 11 pacientes (73,3%). Las lesiones asociadas más frecuentes fueron torácicas, con 12 casos (86,7%), seguidas de ortopédicas, con 9 (60%). El tratamiento de elección fue quirúrgico en 11 casos (73,3%) y médico con-servador en 4 (26,7%). Falleció una paciente tratada de forma conservadora por lesión cerebral irreversible.

Conclusiones

Las lesiones traqueobronquiales pueden tratarse de forma conservadora si cumplen criterios estric-tos de selección. El tamaño o la localización no debe ser un criterio para la elección del tratamiento quirúrgico.

Palabras clave:
Lesiones traqueobronquiales
Traumatismo
Rotura bronquial
Enfisema subcutáneo
Broncoscopia
Toracotomía
Full text is only aviable in PDF
REFERENCES
[1]
H Kaloud, FM Smolle-Juettner, G Prause, WF List.
Iatrogenic ruptures of the tracheobronchial tree.
Chest, 112 (1997), pp. 774-778
[2]
HS Hofmann, G Rettig, J Radke, H Neef, RE Silber.
Iatrogenic ruptures of the tracheobronchial tree.
Eur J Cardiothorac Surg, 21 (2002), pp. 649-652
[3]
JF Burke.
Early diagnosis of traumatic rupture of the bronchus.
JAMA, 181 (1962), pp. 682-686
[4]
J Huh, JC Milliken, JC Chen.
Management of tracheobronchial injuries following blunt and penetrating trauma.
Am Surg, 63 (1997), pp. 896-899
[5]
M Kaptanoglu, K Dogan, A Nadir, U Gonlugur, I Akkurt, Z Seyfikli, et al.
Tracheobronchial rupture: a considerable risk for young teenagers.
Int J Pediatr Otorhinolaryngol, 62 (2002), pp. 123-128
[6]
AE Balci, N Eren, S Eren, R Ulku.
Surgical treatment of posttraumatic tracheobronchial injuries: 14-year experience.
Eur J Cardiothorac Surg, 22 (2002), pp. 984-989
[7]
MM Rossbach, SB Johnson, MA Gómez, EY Sako, OL Miller, JH Calhoon.
Management of major tracheobronchial injuries: a 28-year experience.
Ann Thorac Surg, 65 (1998), pp. 182-186
[8]
PB Angood, EL Attia, RA Brown, DS Mulder.
Extrinsic civilian trauma to the larynx and cervical trachea—important predictors of long-term morbidity.
J Trauma, 26 (1986), pp. 869-873
[9]
AC Kiser, SM O'Brien, FC Detterbeck.
Blunt tracheobronchial injuries: treatment and outcomes.
Ann Thorac Surg, 71 (2001), pp. 2059-2065
[10]
P Borasio, F Ardissone, G Chiampo.
Post-intubation tracheal rupture. A report on ten cases.
Eur J Cardiothorac Surg, 12 (1997), pp. 98-100
[11]
DC Cassada, MP Munyikwa, MP Moniz, RA Dieter Jr, GF Schuchmann, BL Enderson.
Acute injuries of the trachea and major bronchi: importance of early diagnosis.
Ann Thorac Surg, 69 (2000), pp. 1563-1567
[12]
A Mussi, MC Ambrogi, A Ribechini, M Lucchi, F Menoni, CA Angeletti.
Acute major airway injuries: clinical features and management.
Eur J Cardiothorac Surg, 20 (2001), pp. 46-51
[13]
D Sternfeld, S Wright.
Tracheal rupture and the creation of a false passage after emergency intubation.
Ann Emerg Med, 42 (2003), pp. 88-92
[14]
P Carbognani, A Bobbio, L Cattelani, E Internullo, D Caporale, M Rusca.
Management of postintubation membranous tracheal rupture.
Ann Thorac Surg, 77 (2004), pp. 406-409
[15]
J Jougon, M Ballester, E Choukroun, J Dubrez, G Reboul, JF Velly.
Conservative treatment for postintubation tracheobronchial rupture.
Ann Thorac Surg, 69 (2000), pp. 216-220
[16]
HM Ross, FJ Grant, RS Wilson, ME Burt.
Nonoperative management of tracheal laceration during endotracheal intubation.
Ann Thorac Surg, 63 (1997), pp. 240-242
[17]
J Zapatero, J Flandes, R Penalver, L Madrigal, J Lago, SD Reboiras, et al.
Tratamiento de rupturas traqueobronquiales: una revisión de 6 casos.
Arch Bronconeumol, 32 (1996), pp. 222-224
[18]
LJ Buitrago, L Molins, JE Boada, JJ Sopena, G Vidal.
Tratamiento conservador de 2 lesiones traqueales secundarias a intubación anéstesica.
Arch Bronconeumol, 33 (1997), pp. 151-153
[19]
MM Rossbach, SB Johnson, MA Gómez, EY Sako, OL Miller, JH Calhoon.
Management of major tracheobronchial injuries: a 28-year experience.
Ann Thorac Surg, 65 (1998), pp. 182-186
[20]
S Gabor, H Renner, H Pinter, O Sankin, A Maier, F Tomaselli, et al.
Indications for surgery in tracheobronchial ruptures.
Eur J Cardiothorac Surg, 20 (2001), pp. 399-404
[21]
JD Richardson.
Outcome of tracheobronchial injuries: a long-term perspective.
[22]
A Tcherveniakov, P Tchalakov, P Tcherveniakov.
Traumatic and iatrogenic lesions of the trachea and bronchi.
Eur J Cardiothorac Surg, 19 (2001), pp. 19-24
[23]
T Angelillo-Mackinlay.
Transcervical repair of distal membranous tracheal laceration.
Ann Thorac Surg, 59 (1995), pp. 531-532
Copyright © 2005. Sociedad Española de Neumología y Cirugía Torácica (SEPAR)
Archivos de Bronconeumología
Article options
Tools

Are you a health professional able to prescribe or dispense drugs?