Endoscopic treatment with fibrin glue of post-intubation tracheal laceration

Abstract

Post-intubation tracheal laceration (PITL) is a rare and potential life-threatening condition requiring prompt diagnosis and treatment. A conservative treatment is indicated in patients with laceration <2 cm in length while surgery is the treatment of choice for laceration >4 cm. For laceration between 2-4 cm, the best treatment is debate; some authors recommend surgery while others do not definitely exclude endoscopic treatment. Herein, we reported the endoscopic treatment with fibrin glue of PITL.The procedure is performed using a standard video-bronchoscopy in operating room; the patient is in spontaneous breathing and deep sedation. After identification of tracheal laceration, the fibrin glue is injected through a dedicated double lumen catheter into the lesion. After mixing both components of fibrin glue,

Prognostic Factors for Iatrogenic Tracheal Rupture: A Single-Center Retrospective Cohort Study

“…In recent years, the number of publications favoring nonsurgical treatments has increased considerably [6,11,18,20,21]. Nonsurgical treatments include either strictly conservative treatment via frequent bronchoscopic evaluation, local fibrin-glue application, or the placement of stents [11,14,18,[20][21][22]. In our study, nonsurgical patients were either too unstable for surgical intervention, due to critical underlying conditions, or healthy enough to undergo early tracheal tube removal and spontaneous breathing.…”

“…There is certainly a gray zone of patients who may benefit from both surgical and nonsurgical treatment, and each center has to determine the strengths and weaknesses for each individual patient, according to existing infrastructure, adjusting for local treatment protocols [13,14]. Future studies should further explore how alternative surgical approaches (i.e., endoscopy) may be transferred into broader clinical practice [22,23].…”

Iatrogenic Tracheal Injuries: Case Series and Review of the Literature

“…However, there is a more recent trend toward conservative management [1, 7]. Conservative management may be appropriate for injury <2 cm, mild emphysema, and either minimal, non-progressive symptoms without air leakage if breathing spontaneously, or uncomplicated mechanical ventilation with no loss of tidal volumes [1, 2, 8, 9]. Surgical management may be appropriate for injury >2 cm, full thickness injury, progressive emphysema, or insufficient mechanical ventilation [1, 2, 9].…”

Fibrin glue to fix metallic airway stent

“…To fix the stent using laparoscopic tacks as reported by Andreetti et al (3,4) for tracheal stent was technically unfeasible in our case since the proximal end of the stent was located too distally for allowing the tacks deployment. FG has used in a variety of cardiothoracic situations (5)(6)(7)(8) but no papers before the present have reported its use for fixing tracheobronchial Available online: http://www.asvide.com/article/view/29638 Video 1. The video edited the main steps of the procedure as the resection of the tumor, the deployment of the stent, and its fixation with fibrin glue SEMS.…”