Successful Management of Accidental Tracheal Tear using an Adaptation of an Endotracheal Tube

Although tracheal injury during esophagectomy is a rare complication, it is a dreaded one when encountered in the intraoperative period. It can be managed conservatively or by primary repair. We report an incident and successful management of tracheal injury during transhiatal esophagectomy performe...

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Bibliographic Details
Published inJournal of Marine Medical Society Vol. 24; no. 3; pp. 120 - S121
Main Authors Paul, Shamik, Kiran, S, Guha, Deborshi, Kaur, Kaminder, Paul, Debashish
Format Journal Article
LanguageEnglish
Published Medknow Publications and Media Pvt. Ltd 01.07.2022
Wolters Kluwer Medknow Publications
Subjects
airway management
Care and treatment
esophagectomy
Esophagus
Injuries
injury
innovation
Penetrating wounds
Risk factors
Surgery
Trachea
India
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Summary:Although tracheal injury during esophagectomy is a rare complication, it is a dreaded one when encountered in the intraoperative period. It can be managed conservatively or by primary repair. We report an incident and successful management of tracheal injury during transhiatal esophagectomy performed in a case of carcinoma esophagus (upper one-third). The tracheal rent of the posterior wall of the trachea was repaired with bovine pericardial patch through a right thoracotomy we added one endotracheal tube (ETT), cut at 19 cm mark from its patient end, reversed to another ETT with a refashioned ETT connector. This innovation gave us enough length to place the tube comfortably inside the left main bronchus without making the ETT cuff herniate inside the tracheal tear. The tracheal rent was repaired with bovine pericardial patch hitched with pledgeted sutures through a right thoracotomy. Postrepair, the patient was electively ventilated; gastric pull-up was postponed pending the healing of the trachea. At the time of second surgery, we had to take all the precautions not to disrupt the repaired wall. The tracheal wall was found intact with some permanent deformity but functionally competent.
ISSN:0975-3605
DOI:10.4103/jmms.jmms_77_21