초록접수 현황
| 15F-094 | 구연 발표 |
Outcome of Surgical Repair of Trachea Injury in Penetrating Trauma and Blunt Trauma
김창완¹, 박종명¹, 안효영², 조정수², 김영대², 김선희³, 황정주³, 조현민³, 김도형¹
부산대학교 의과대학 양산부산대학교병원 흉부외과학교실¹, 부산대학교 의과대학 부산대학교병원 흉부외과학교실², 부산대학교 의과대학 부산대학교병원 외상외과³
Background : Trachea injury caused by trauma is rare complication, but can be life threatening. Furthermore, the studies on traumatic trachea injury are not sufficient due to its rarity. The objective of this study was to evaluate the surgical outcome of trachea injuries and the difference between penetrating trauma group and blunt trauma group.
Methods : From January 2000 to June 2015, 37patients underwent tracheal repair operation due to traumatic trachea injury. We divided these patients into three groups : penetrating group, blunt group, iatrogenic group. We excluded iatrogenic group and we retrospectively reviewed the clinical parameters of the two groups.
Results : The mean age of patients was 43.5±18.6(range,5-75), 19 patients(83.3%) were male and 4 patients(16.7%) were female. In penetrating group, injury mechanisms were stab wound(10/12, 83.3%), high speed metal splinter(1/12,8.3%) and gun shot(1/12, 8.4%). In blunt trauma group, injury mechanisms were TA(6/11, 54.5%) , fall down(3/11, 27.3%) , slip down(1/11, 9.1%) and the other(1/11, 9.1%). The mean time from accident to operation room was 18.4±29.2(range, 3-120) hours , 6.5±3.5(range, 3-14) hours in penetrating group and 31.4±38.9(range, 4-120)hours in blunt group. (p=0.038). In blunt group, there were more delayed operations than in penetrating group statistically significantly. In penetrating group, primary trachea repair was performed in 10 cases(83.3%), trachea resection and end to end anastomosis was performed in 2 cases(16.7%). In blunt group, primary trachea repair was performed in 9 cases(82.2%), and trachea resection and end to end anastomosis was performed in 2patients(17.8%). (p=0.67). There were no significant differences between the two groups in aspect of surgical complexity. In penetrating group, injury near trachea was found in 10 cases(83.3%), in blunt group, it was found in only one case(9.1%). (p=0.007). Unlike our expectations, associated injuries near trachea were more common in penetrating group. The complication associated with operation was found in 3cases(25%) in penetrating group, and in 1 case(9.1%) in blunt group.(p=0.329). There was no mortality in both groups.
Conclusion : Generally the mortality of traumatic trachea injury is thought to be high due to its visible severities. However, several previous studies reported low mortality of surgical management of traumatic trachea injury, and our research results supported them. Based on our experience, on condition that air way patency is well maintained, surgical management of traumatic trachea injury is a safe procedure for both penetrating trauma and blunt trauma patients.
Methods : From January 2000 to June 2015, 37patients underwent tracheal repair operation due to traumatic trachea injury. We divided these patients into three groups : penetrating group, blunt group, iatrogenic group. We excluded iatrogenic group and we retrospectively reviewed the clinical parameters of the two groups.
Results : The mean age of patients was 43.5±18.6(range,5-75), 19 patients(83.3%) were male and 4 patients(16.7%) were female. In penetrating group, injury mechanisms were stab wound(10/12, 83.3%), high speed metal splinter(1/12,8.3%) and gun shot(1/12, 8.4%). In blunt trauma group, injury mechanisms were TA(6/11, 54.5%) , fall down(3/11, 27.3%) , slip down(1/11, 9.1%) and the other(1/11, 9.1%). The mean time from accident to operation room was 18.4±29.2(range, 3-120) hours , 6.5±3.5(range, 3-14) hours in penetrating group and 31.4±38.9(range, 4-120)hours in blunt group. (p=0.038). In blunt group, there were more delayed operations than in penetrating group statistically significantly. In penetrating group, primary trachea repair was performed in 10 cases(83.3%), trachea resection and end to end anastomosis was performed in 2 cases(16.7%). In blunt group, primary trachea repair was performed in 9 cases(82.2%), and trachea resection and end to end anastomosis was performed in 2patients(17.8%). (p=0.67). There were no significant differences between the two groups in aspect of surgical complexity. In penetrating group, injury near trachea was found in 10 cases(83.3%), in blunt group, it was found in only one case(9.1%). (p=0.007). Unlike our expectations, associated injuries near trachea were more common in penetrating group. The complication associated with operation was found in 3cases(25%) in penetrating group, and in 1 case(9.1%) in blunt group.(p=0.329). There was no mortality in both groups.
Conclusion : Generally the mortality of traumatic trachea injury is thought to be high due to its visible severities. However, several previous studies reported low mortality of surgical management of traumatic trachea injury, and our research results supported them. Based on our experience, on condition that air way patency is well maintained, surgical management of traumatic trachea injury is a safe procedure for both penetrating trauma and blunt trauma patients.
책임저자: 김도형
부산대학교 의과대학 양산부산대학교병원 흉부외과학교실
연락처 : 김창완, Tel: 055-360-2127 , E-mail : asparag@naver.com
