{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T13:31:13Z","timestamp":1779888673822,"version":"3.53.1"},"reference-count":37,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,5,9]],"date-time":"2025-05-09T00:00:00Z","timestamp":1746748800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:p>Minimally invasive techniques such as thoracoscopic or robotic surgical approaches for oesophageal pathologies have been gaining traction as the preferred method of surgical technique. McKeown\u2019s minimally invasive oesophagectomy has been shown to reduce hospitalisation, with reduced cardiopulmonary morbidities. However, it is not without complications, and an iatrogenic tracheobronchial injury (TBI) could occur intraoperatively during anatomical plane dissection. We report a case of iatrogenic posterior membranous tracheal injury during the thoracic dissection of a McKeown\u2019s oesophagectomy, detected intraoperatively and patient recovered without any complications. The diagnosis of TBI involves a multicentric approach. Confirmation of the diagnosis and classification of TBI based on clinical signs, radiological studies, and endoscopy procedures such as bronchoscopy are necessary to tailor the best possible management for the patient. In cases where a full-thickness airway defect exceeds 2 cm and is detected intraoperatively, immediate primary repair is advised to optimize outcomes. TBI pose significant clinical challenges, particularly in cases of iatrogenic injury during procedures such as minimally invasive oesophagectomy. While the overall incidence of TBI remains low, awareness of risk factors and vigilant monitoring during procedures is paramount. While TBI remains rare, its management shares principles with oncological oesophageal surgery, making this case pertinent to surgical oncology practice. The evolving landscape of diagnostic techniques, including bronchoscopy and advanced imaging modalities, facilitates prompt and accurate identification of injuries, enabling timely intervention.<\/jats:p>","DOI":"10.3389\/fonc.2025.1560437","type":"journal-article","created":{"date-parts":[[2025,5,9]],"date-time":"2025-05-09T04:11:00Z","timestamp":1746763860000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Posterior membranous tracheal injury during mckeown oesophagectomy. A case report with literature review"],"prefix":"10.3389","volume":"15","author":[{"given":"Theeran Kaur","family":"Gill","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guo Hou","family":"Loo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guhan","family":"Muthkumaran","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nik Ritza","family":"Kosai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,5,9]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezs031","article-title":"Comparison of perioperative outcomes following open versus minimally invasive Ivor Lewis oesophagectomy at a single, high-volume centre","volume":"42","author":"Sihag","year":"2012","journal-title":"Eur J Cardiothorac Surg"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2014.01.054","article-title":"Short-term outcomes of minimally invasive Ivor-Lewis esophagectomy for esophageal cancer","volume":"97","author":"Xie","year":"2014","journal-title":"Ann Thorac Surg"},{"key":"B3","doi-asserted-by":"publisher","first-page":"52","DOI":"10.1186\/s12957-022-02527-z","article-title":"Advantages of McKeown minimally invasive oesophagectomy for the treatment of oesophageal cancer: propensity score matching analysis of 169 cases","volume":"52","author":"Xie","year":"2022","journal-title":"World J Surg Oncol"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1001\/archpedi.1949.02030050388009","article-title":"Fatal interstitial and mediastinal emphysema following accidental needle perforations of the trachea during jugular venipuncture","volume":"78","author":"P.","year":"1949","journal-title":"Am J Dis Child"},{"key":"B5","doi-asserted-by":"publisher","first-page":"rjy277","DOI":"10.1093\/jscr\/rjy277","article-title":"AGM. Tracheopleural fistula after thoracoscopic esophagectomy: novel therapeutic approach with pericardial and intercostal muscle flaps","volume":"2018","author":"Rafieian","year":"2018","journal-title":"J Surg Case Rep"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1097\/JS9.0000000000000373","article-title":"The SCARE 2023 guideline: updating consensus Surgical CAse REport (SCARE) guidelines","volume":"109","author":"Sohrabi","year":"2023","journal-title":"Int J Surg"},{"key":"B7","doi-asserted-by":"publisher","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":"B8","doi-asserted-by":"publisher","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":"B9","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e31814697f2","article-title":"Two thousand transhiatal esophagectomies: changing trends, lessons learned","volume":"246","author":"Orringer","year":"2007","journal-title":"Ann Surg"},{"key":"B10","doi-asserted-by":"publisher","first-page":"804","DOI":"10.1002\/jso.v109.8","article-title":"Tracheobronchial injury in the setting of an esophagectomy for cancer: postoperative discovery of a bad omen","volume":"109","author":"Koshenkov","year":"2014","journal-title":"J Surg Oncol"},{"key":"B11","doi-asserted-by":"publisher","first-page":"1960","DOI":"10.1016\/j.athoracsur.2007.01.042","article-title":"Management of Iatrogenic tracheobronchial injuries: a retrospective analysis of 29 cases","volume":"83","author":"Schneider","year":"2007","journal-title":"Ann Thorac Surg"},{"key":"B12","doi-asserted-by":"publisher","first-page":"117","DOI":"10.1186\/1749-8090-9-117","article-title":"Airway trauma: a review on epidemiology, mechanisms of injury, diagnosis and treatment","volume":"9","author":"Prokakis","year":"2014","journal-title":"J Cardiothorac Surg"},{"key":"B13","doi-asserted-by":"publisher","first-page":"663","DOI":"10.1093\/bja\/aen038","article-title":"Role of routine chest radiography after percutaneous dilatational tracheostomy","volume":"100","author":"Kumar","year":"2008","journal-title":"Br J Anaesth"},{"key":"B14","article-title":"Tracheal Injury during esophagectomy-incidence, treatment and outcome","volume":"32","author":"George","year":"2011","journal-title":"Trop Gastroenterol"},{"key":"B15","doi-asserted-by":"publisher","first-page":"108010","DOI":"10.1016\/j.ijscr.2023.108010","article-title":"Management of an intraoperative tracheal injury during a Mckeown oesophagectomy: A case report","volume":"105","author":"Munasinghe","year":"2023","journal-title":"Int J Surg Case Rep"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.21037\/jtd-2019-as-05","article-title":"Management of tracheobronchial injuries","volume":"12","author":"Welter","year":"2020","journal-title":"J Thorac Dis"},{"key":"B17","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1016\/j.thorsurg.2013.10.006","article-title":"Repair of tracheobronchial injuries","volume":"24","author":"S.","year":"2014","journal-title":"Thorac Surg Clin"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1111\/j.1445-2197.2006.03738.x","article-title":"Tracheobronchial injuries from blunt trauma","volume":"76","author":"Wong","year":"2006","journal-title":"ANZ J Surg"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejrad.2006.04.026","article-title":"Acute tracheobronchial injuries: Impact of imaging on diagnosis and management implications","volume":"59","author":"Scaglione","year":"2006","journal-title":"Eur J Radiol"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.21037\/jtd.2017.01.19","article-title":"Update on the diagnosis and treatment of tracheal and bronchial injury","volume":"2017","author":"Zhao","year":"2017","journal-title":"J Thorac Dis"},{"key":"B21","doi-asserted-by":"publisher","first-page":"864369","DOI":"10.1155\/2014\/864369","article-title":"Multidetector computer tomography: evaluation of blunt chest trauma in adults","volume":"2014","author":"Palas","year":"2014","journal-title":"Radiol Res Pract"},{"key":"B22","article-title":"Diagnosis of complete mainstem bronchus avulsion by 3-dimensional spiral CT scan of the chest","volume":"58","author":"Baisi","year":"2003","journal-title":"Minerva Chir"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-004-2538-3","article-title":"Acute mediastinitis: spectrum of computed tomography findings","volume":"15","author":"Exarhos","year":"2005","journal-title":"Eur Radiol"},{"key":"B24","article-title":"Strategies for diagnosis and treatment of iatrogenic tracheal ruptures","volume":"77","author":"Deja","year":"2011","journal-title":"Minerva Anestesiol"},{"key":"B25","doi-asserted-by":"publisher","first-page":"595","DOI":"10.1016\/j.chest.2018.07.018","article-title":"Treatment of tracheobronchial injuries: A contemporary review","volume":"155","author":"Grewal","year":"2019","journal-title":"Chest Mar"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejcts.2009.07.034","article-title":"Tracheal lacerations after endotracheal intubation: a proposed morphological classification to guide non-surgical treatment","volume":"37","author":"Cardillo","year":"2010","journal-title":"Eur J Cardiothorac Surg"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(96)01077-6","article-title":"Nonoperative management of tracheal laceration during endotracheal intubation","volume":"63","author":"Ross","year":"1997","journal-title":"Ann Thorac Surg"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejcts.2009.01.053","article-title":"Tracheal rupture after endotracheal intubation: a literature systematic review","volume":"35","author":"Mi\u00f1ambres","year":"2009","journal-title":"Eur J Cardiothorac Surg"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1378\/chest.130.2.412","article-title":"Management of postintubation tracheal membrane rupture","volume":"2006","author":"Conti","year":"2006","journal-title":"Chest"},{"key":"B30","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1055\/s-0035-1570376","article-title":"Management of postintubational tracheal injury by endoscopic stent placement: case report and review of the literature","volume":"5","author":"Geltner","year":"2016","journal-title":"Thorac Cardiovasc Surgeon Rep"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.3978\/j.issn.2072-1439.2014.03.30","article-title":"Conservative management of post-intubation tracheal tears\u2014report of three cases","volume":"6","author":"Ov\u00e1ri","year":"2014","journal-title":"J Thorac Dis"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(03)01344-4","article-title":"Management of postintubation membranous tracheal rupture","volume":"77","author":"Carbognani","year":"2004","journal-title":"Ann Thorac Surg"},{"key":"B33","doi-asserted-by":"publisher","first-page":"46","DOI":"10.1016\/S1010-7940(01)00702-3","article-title":"Acute major airway injuries: clinical features and management","volume":"20","author":"Mussi","year":"2001","journal-title":"Eur J Cardiothorac Surg"},{"key":"B34","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1016\/j.thorsurg.2007.03.005","article-title":"Traumatic injury to the trachea and bronchus","volume":"17","author":"Karmy-Jones","year":"2007","journal-title":"Thorac Surg Clin"},{"key":"B35","doi-asserted-by":"publisher","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\u2019s opinion","volume":"22","author":"Lee","year":"2016","journal-title":"Ann Thorac Cardiovasc Surg"},{"key":"B36","doi-asserted-by":"publisher","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":"B37","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000003031","article-title":"Robot-assisted minimally invasive thoracolaparoscopic esophagectomy versus open transthoracic esophagectomy for resectable esophageal cancer: a randomized controlled trial","volume":"269","author":"van der Sluis","year":"2019","journal-title":"Ann Surg"}],"container-title":["Frontiers in Oncology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2025.1560437\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,9]],"date-time":"2025-05-09T04:11:02Z","timestamp":1746763862000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2025.1560437\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,9]]},"references-count":37,"alternative-id":["10.3389\/fonc.2025.1560437"],"URL":"https:\/\/doi.org\/10.3389\/fonc.2025.1560437","relation":{},"ISSN":["2234-943X"],"issn-type":[{"value":"2234-943X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,9]]},"article-number":"1560437"}}