AUTHOR=Cardillo Giuseppe , Ricciardi Sara , Forcione Anna Rita , Carbone Luigi , Carleo Francesco , Di Martino Marco , Jaus Massimo O. , Perdichizzi Salvatore , Scarci Marco , Ricci Alberto , Dello Iacono Raffaele , Lucantoni Gabriele , Galluccio Giovanni 

TITLE=Post-intubation tracheal lacerations: Risk-stratification and treatment protocol according to morphological classification

JOURNAL=Frontiers in Surgery

VOLUME=9

YEAR=2022

URL=https://www.frontiersin.org/journals/surgery/articles/10.3389/fsurg.2022.1049126

DOI=10.3389/fsurg.2022.1049126

ISSN=2296-875X

ABSTRACT=<sec><title>Background</title><p>Post-intubation tracheal laceration (PITL) is a rare condition (0.005% of intubations). The treatment of choice has traditionally been surgical repair. Following our first report in 2010 of treatment protocol tailored to a risk-stratified morphological classification there is now clear evidence that conservative therapy represents the gold standard in the majority of patients. In this paper we aim to validate our risk-stratified treatment protocol through the largest ever reported series of patients.</p></sec><sec><title>Methods</title><p>This retrospective analysis is based on a prospectively collected series (2003–2020) of 62 patients with PITL, staged and treated according to our revised morphological classification.</p></sec><sec><title>Results</title><p>Fifty-five patients with Level I (#8), II (#36) and IIIA (#11) PITL were successfully treated conservatively. Six patients with Level IIIB injury and 1 patient with Level IV underwent a surgical repair of the trachea. No mortality was reported. Bronchoscopy confirmed complete healing in all patients by day 30. Statistical analysis showed age only to be a risk factor for PITL severity.</p></sec><sec><title>Conclusions</title><p>Our previously proposed risk-stratified morphological classification has been validated as the major tool for defining the type of treatment in PITL.</p></sec>