A SURGICAL TACTICS IN THE INJURY OF TRACHEA AND BRONCHI IN CHILDREN



Cite item

Full Text

Abstract

Introduction. Tracheal and bronchial injuries in children are not at the last place in the trauma incidence structure . It is an urgent issue for both adult and pediatric surgeons. Purpose. To show ways for obtaining good outcomes in patients with trachea and bronchi rupture. Material and methods. The researchers analyzed outcomes of surgical treatment of 19 patients with trachea and bronchi ruptures. The patients had surgeries at various intervals after the injury: from few hours to 10 days. X-ray and tracheobronchoscopy examinations were made. On the first day after the injury, a radical surgery was performed to restore the airway patency. Late surgical interventions ended with pulmonectomy or lobectomy. At the final stage of the trial, early and long-term results were analyzed. Results. The radical surgical treatment consisting of thoracotomy and complete restoration of anatomical integrity and airway patency had 16 children of various age on the first day after their injury . Surgery lasted for 85 ± 15 min. There were no any complications during the surgery. At the early period of observation after the surgery, a ventilation failure of degree I was seen in 3 patients. Two years later, compensated stenosis of the bronchus without signs of ventilation failure was seen in one child. Three children were operated on in 10 days after their injury. Organ-sparing surgeries were performed in them (lobectomy and pulmonectomy). These surgeries lasted for 130 ± 15 min. At the early postoperative period, all three patients had ventilation failure of degree II. In 2 years, two children developed a persistent deformation of the chest, two children were disabled. Conclusion. A successful treatment of children with lower airways injury may be expected if the radical assistance is provided by a thoracic surgeon and shortly after the injury.

About the authors

V. I. Ponomarev

Omsk State Medical University

Author for correspondence.
Email: pvikust@yandex.ru
ORCID iD: 0000-0002-2555-7994
Россия

A. V. Pisklakov

Omsk State Medical University

Email: noemail@neicon.ru
ORCID iD: 0000-0001-7594-7723
Россия

A. V. Lysov

Omsk State Medical University

Email: noemail@neicon.ru
ORCID iD: 0000-0002-2874-6686
Россия

V. V. Vysotsky

Omsk State Medical University

Email: noemail@neicon.ru
ORCID iD: 0000-0002-9931-8013
Россия

References

  1. Вагнер Е.А. Хирургия повреждений груди. М.: Медицина, 1981.
  2. Богненко С.Ф., Тулупов А.Н., Балабанова О.В. Возможности видеоторакоскопии в диагностике и лечении травматического гемоторакса. Вестник хирургии. 2007; 6: 32-5.
  3. Grillo H. Surgery of the trachea and bronchi. London: 2004.
  4. Соколов В.А., Картавенко В.И., Гараев Д.А., Свирская Л.М. Синдром взаимного отягощения повреждений у пострадавших с сочетанной травмой. Вестник хирургии. 2006; 6: 25-9.
  5. Тулупов А.Н., Шапот Ю.Б. Классификация механических повреждений груди. Вестник хирургии. 2007; 1: 21-4.
  6. Тулупов А.Н., Дворецкий С.Ю., Ивченко Д.Р. Правосторонняя травматическая диафрагмальная грыжа. Вестник хирургии. 2008;5: 87-90.
  7. Greval H.S., Dangayach N.S., Ahmad U, Ghosh S., Gildea T, Mehta A.S. treatment of tracheobronchial injuries: a modern review. Chest. March. 2019; 155 (3): 595-604. (Epub 2018 27 июля)
  8. Пономарёв В.И., Дырул А.К., Бочарников Е.С. Хирургическая тактика в условиях центральной районной больницы при размозжении правого межуточного бронха у ребёнка 10 лет. Грудная и сердечно-сосудистая хирургия. 2011; 3: 61-3.
  9. Скобелев В.А., Разин М.И., Сырчин Э.Ф., Ральников В.В. Тяжёлая сочетанная травма лёгких, диафрагмы, кишечника, селезёнки, позвоночника, спинного мозга. Детская хирургия. 2014; 6: 51-2.
  10. Багненко С.Ф., Шапот Ю.Б., Тулупов А.Н., Лапицкий А.В., Балабанова О.В. Медицинская помощь при механической травме груди и живота на догоспитальном этапе. Вестник хирургии. 2007; 2: 47-50.

Supplementary files

Supplementary Files
Action
1. JATS XML

Copyright (c) 2019

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies