Trakeobronþiyal yaralanmalar

AMAÇ
Bu çalýþmada, trakeobronþiyal yaralanmalarýn taný ve tedavisinde kullanýlan yöntemleri araþtýrdýk ve literatürle karþýlaþtýrmayý amaçladýk.
GEREÇ VE YÖNTEM
Kliniðimizde 2003-2008 yýllarý arasýnda trakeobronþiyal yaralanma nedeni ile ameliyat edilen 9 olgu (7 erkek, 2 kadýn) çalýþmaya dahil edildi. Travma sonrasý trakeobronþiyal yaralanma nedeni ile ameliyat edilen 7 olgu ile entübasyon sonrasý trakeal yaralanma görülen 2 olgu incelendi. Olgular, yaþ, cinsiyet, travma tipi, klinik bulgular, yaralanma bölgesi, uygulanan giriþim ve sonuçlarý açýsýndan deðerlendirildi.
BULGULAR
Yaralanma 6 olguda künt travma, 1 olguda penetran travma sonucu gerçekleþirken, 2 olguda ise iyatrojenikti. Yaralanma 5 olguda trakeal, 4 olguda ise bronþiyal seviyede idi. Bir olguya üst bilobektomi, bir olguya trakeal rezeksiyon ve ucuca anastamoz, 3 olguya uçuca anastomoz ve 4 olguya ise primer tamir yapýldý. Bir olgu ameliyat sýrasýnda, bir olgu ise ameliyat sonrasý erken dönemde kaybedildi.
SONUÇ
Trakeobronþiyal yaralanmalarda erken taný önemlidir. Yaralanmanýn yerinin ve þeklini belirlenmesi için kullanýlan en önemli taný aracý bronkoskopidir. Tedavide rezeksiyondan mümkün olduðunca kaçýnýlmalý ve primer onarým tercih edilmelidir.

Tracheobronchial injuries

BACKGROUND
We aimed in this study to investigate and compare the diagnostic and therapeutic methods in tracheobronchial injuries.
METHODS
Nine cases (7 male, 2 female) operated between 2003 and 2008 because of tracheobronchial injury were included in the study. The cause of tracheobronchial injury was trauma in 7 cases and postintubation laceration in 2 cases. The cases were evaluated in terms of age, sex, type of trauma, clinical findings, localization of injury, performed diagnostic and therapeutic methods, and results.
RESULTS
The causes of tracheobronchial laceration were blunt trauma in 6 cases, penetrating trauma in 1 case and iatrogenic (postintubation) in 2 cases. Lacerations were in the trachea in 5 cases and at the bronchial level in 4 cases. Operations included right upper bilobectomy in 1 case, tracheal resection and end to end anastomosis in 1 case, end to end anastomosis in 3 cases, and primary repair in 4 cases. One case died during the operation and 1 case died postoperatively.
CONCLUSION
In tracheobronchial injuries, early diagnosis and treatment are very important. The most useful method is bronchoscopy for determining the type and localization of the injury. In treatment, primary repair should be preferred over anatomical resections whenever possible.