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

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.

rupture of trachea and bronchi, surgical treatment, children