{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T02:21:19Z","timestamp":1792290079710,"version":"4.4.0"},"reference-count":14,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"C","license":[{"start":{"date-parts":[[2023,4,1]],"date-time":"2023-04-01T00:00:00Z","timestamp":1680307200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2023,4,1]],"date-time":"2023-04-01T00:00:00Z","timestamp":1680307200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2023,3,19]],"date-time":"2023-03-19T00:00:00Z","timestamp":1679184000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction and importance:<\/jats:title>\n                    <jats:p>Tracheobronchial injuries are uncommon complications during oesophagectomies adopting blind dissection or thoracoscopy. Neoadjuvant chemo-radiotherapy is considered a risk factor while double-lumen endotracheal tube insertion and direct surgical damage are other related causalities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Presentation of case:<\/jats:title>\n                    <jats:p>A 65-year-old male underwent a Mckeown oesophagectomy with a right thoracotomy for a mid-oesophageal carcinoma. During the latter stages of cervical dissection and oesophageal mobilization, a 2-cm tracheal injury was noted in the posterior membranous trachea. It was repaired with 2.0 prolene with interrupted sutures and local transposition muscle flap using prevertebral muscles. Post-operatively, he was ventilated in view of prolonged surgery and the probability of airway oedema with the double-lumen ET tube. A transient bubbling of the intercostal drain was managed conservatively and attributed to a secondary pneumothorax. He was extubated and made an uncomplicated recovery. At 2 years, he did not have any tracheal stenosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical discussion:<\/jats:title>\n                    <jats:p>If diagnosed intraoperatively and for sizes &gt;2 cm, tracheobronchial injuries should be repaired. Various techniques exist with differing evidence. Repair with non-absorbable sutures, use of synthetic grafts, innate tissue such as intercostal and pectoral muscle flaps, and pericardial and pleural flaps are all being used. Early extubation might be useful provided other criteria for extubation are met.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Tracheobronchial injuries during oesophagectomies present a surplus challenge to both the anaesthetist and the surgeon. Collective decision-making tailored to the patient and close monitoring during the postoperative phase would result in good outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Highlights<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1016\/j.ijscr.2023.108010","type":"journal-article","created":{"date-parts":[[2023,3,21]],"date-time":"2023-03-21T06:25:39Z","timestamp":1679379939000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":6,"title":["Management of an intraoperative tracheal injury during a Mckeown oesophagectomy"],"prefix":"10.1097","volume":"105","author":[{"given":"B.M.","family":"Munasinghe","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.T.","family":"Karunatileke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-44-20260318","doi-asserted-by":"crossref","first-page":"S826","DOI":"10.21037\/jtd.2017.03.173","article-title":"McKeown or Ivor Lewis totally minimally invasive esophagectomy for cancer of the esophagus and gastroesophageal junction: systematic review and meta-analysis","volume":"9","author":"van Workum","year":"2017","journal-title":"J. Thorac. Dis"},{"key":"R2-44-20260318","first-page":"309","article-title":"Tracheal injury during oesophagectomy-incidence, treatment and outcome","volume":"32","author":"George","year":"2012","journal-title":"Trop. Gastroenterol"},{"key":"R4-44-20260318","first-page":"309","article-title":"Tracheal injury during oesophagectomy--incidence, treatment and outcome","volume":"32","author":"George","year":"2011","journal-title":"Trop. Gastroenterol"},{"key":"R5-44-20260318","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1016\/j.ijsu.2020.10.034","article-title":"The SCARE 2020 guideline: updating consensus surgical CAse REport (SCARE) guidelines","volume":"1","author":"Agha","year":"2020","journal-title":"Int. J. Surg"},{"key":"R6-44-20260318","first-page":"181","article-title":"Successful management of a tracheal laceration during transhiatal esophagectomy with double lumen tube in situ","volume":"22","author":"Das","year":"2006","journal-title":"J. Anaesthesiol. Clin. Pharmacol"},{"key":"R7-44-20260318","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1016\/j.asjsur.2015.12.009","article-title":"An unusual salvage technique for posterior tracheal membranous laceration associated with transhiatal esophagectomy: a transcervical-transsternal approach","volume":"40","author":"Rasihashemi","year":"2017","journal-title":"Asian J. Surg"},{"key":"R8-44-20260318","doi-asserted-by":"crossref","first-page":"154","DOI":"10.5090\/jcs.20.055","article-title":"Robotic intraoperative tracheobronchial repair during minimally invasive 3-stage esophagectomy","volume":"54","author":"Marano","year":"2021","journal-title":"J. Chest Surg"},{"key":"R9-44-20260318","doi-asserted-by":"crossref","first-page":"2652","DOI":"10.18203\/2349-2902.isj20193014","article-title":"Managing iatrogenic tracheal injury during esophagectomy","volume":"6","author":"Pegu","year":"2019","journal-title":"Int. Surg. J"},{"key":"R10-44-20260318","doi-asserted-by":"crossref","first-page":"388","DOI":"10.1016\/j.ijscr.2013.01.028","article-title":"Persistent air-leak after transhiatal oesophagectomy: a case report","volume":"4","author":"Khan","year":"2013","journal-title":"Int. J. Surg. Case Rep"},{"key":"R11-44-20260318","doi-asserted-by":"crossref","first-page":"348","DOI":"10.5761\/atcs.oa.16-00189","article-title":"Does surgical repair still have a role for iatrogenic tracheobronchial rupture? Clinical analysis of a thoracic surgeon's opinion","volume":"22","author":"Lee","year":"2016","journal-title":"Ann. Thorac. Cardiovasc. Surg"},{"key":"R12-44-20260318","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1510\/icvts.2005.117242","article-title":"Iatrogenic tracheobronchial ruptures - treatment and outcomes","volume":"5","author":"Leinung","year":"2006","journal-title":"Interact. Cardiovasc. Thorac. Surg"},{"key":"R13-44-20260318","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1016\/j.ijscr.2019.02.045","article-title":"Case report of successful management of intraoperative tracheal rupture during thoracoscopic esophageal resection in patient with esophageal cancer","volume":"57","author":"Khitaryan","year":"2019","journal-title":"Int. J. Surg. Case Rep"},{"key":"R14-44-20260318","doi-asserted-by":"crossref","first-page":"757","DOI":"10.1007\/s00595-012-0315-5","article-title":"Intraoperative management of tracheobronchial rupture after double-lumen tube intubation","volume":"43","author":"Ceylan","year":"2013","journal-title":"Surg. Today"},{"key":"R15-44-20260318","doi-asserted-by":"crossref","first-page":"1093","DOI":"10.1067\/mtc.2000.110182","article-title":"Injury to the major airways during subtotal esophagectomy: incidence, management, and sequelae","volume":"120","author":"Hulscher","year":"2000","journal-title":"J. Thorac. Cardiovasc. Surg"}],"container-title":["International Journal of Surgery Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2210261223001384?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2210261223001384?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.lww.com\/10.1016\/j.ijscr.2023.108010","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T10:04:02Z","timestamp":1773828242000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1016\/j.ijscr.2023.108010"}},"subtitle":["A case report"],"short-title":[],"issued":{"date-parts":[[2023,4]]},"references-count":14,"journal-issue":{"issue":"C","published-print":{"date-parts":[[2023]]}},"URL":"https:\/\/doi.org\/10.1016\/j.ijscr.2023.108010","relation":{},"ISSN":["2210-2612"],"issn-type":[{"value":"2210-2612","type":"print"}],"subject":[],"published":{"date-parts":[[2023,4]]}}}