Stenting treatment is a minimally traumatic and effective alternative to surgical repair for iatrogenic tracheobronchial lesion

Antonio D’Andrilli, Erino A. Rendina


Iatrogenic tracheobronchial injuries are rare but life- threatening events, most frequently due to complication of endotracheal intubation or percutaneous tracheostomy. Their incidence is low (0.005–0.2% after double lumen or emergency single lumen intubation and up to 0.7% after percutaneous tracheostomy), but related mortality can be high and has been generally reported between 11% and 42% (1-5). Surgical repair has been considered the treatment of choice for a long time. More recently, along with the progressive evolution of interventional bronchoscopy, minimally invasive endoscopic treatment has gained diffusion as an effective alternative. In particular, increasing experience and technical improvement in airway stenting has significantly enlarged the spectrum of application of these techniques to treat tracheobronchial injuries. The same endoscopic techniques are employed to treat ischemic tracheobronchial lesions occurring after major lung surgery, which are usually more difficult to manage because of the potential extension of airway defects due to vascular insufficiency of the tracheobronchial wall after surgical dissection.