{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T01:33:32Z","timestamp":1789090412960,"version":"build-2803163510"},"reference-count":36,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,11,23]],"date-time":"2022-11-23T00:00:00Z","timestamp":1669161600000},"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. Surg."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats: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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective analysis is based on a prospectively collected series (2003\u20132020) of 62 patients with PITL, staged and treated according to our revised morphological classification.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats: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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our previously proposed risk-stratified morphological classification has been validated as the major tool for defining the type of treatment in PITL.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fsurg.2022.1049126","type":"journal-article","created":{"date-parts":[[2022,11,23]],"date-time":"2022-11-23T01:06:47Z","timestamp":1669165607000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":23,"title":["Post-intubation tracheal lacerations: Risk-stratification and treatment protocol according to morphological classification"],"prefix":"10.3389","volume":"9","author":[{"given":"Giuseppe","family":"Cardillo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Ricciardi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna Rita","family":"Forcione","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luigi","family":"Carbone","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Carleo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Di Martino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimo O.","family":"Jaus","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salvatore","family":"Perdichizzi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Scarci","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Ricci","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raffaele","family":"Dello Iacono","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriele","family":"Lucantoni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Galluccio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,11,23]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"521","DOI":"10.1007\/s00134-018-5450-z","article-title":"Post-intubation tracheal laceration","volume":"45","author":"Nobre de Jesus","year":"2019","journal-title":"Intensive Care Med"},{"key":"B2","doi-asserted-by":"publisher","first-page":"6","DOI":"10.1510\/icvts.2010.248641","article-title":"A new technique for complete intraluminal repair of iatrogenic posterior tracheal lacerations","volume":"12","author":"Welter","year":"2011","journal-title":"Interact Cardiovasc Thorac Surg"},{"key":"B3","doi-asserted-by":"publisher","first-page":"1437","DOI":"10.1016\/j.injury.2010.08.038","article-title":"Surgical decision making in tracheobronchial injuries on the basis of clinical evidences and the injury's Anatomical setting: a retrospective analysis","volume":"43","author":"Koletsis","year":"2012","journal-title":"Injury"},{"key":"B4","doi-asserted-by":"publisher","first-page":"1265","DOI":"10.1016\/j.athoracsur.2009.07.093","article-title":"Nonoperative management of postintubation tracheal injuries","volume":"89","author":"Fong","year":"2010","journal-title":"Ann Thorac Surg"},{"key":"B5","doi-asserted-by":"publisher","first-page":"686","DOI":"10.1016\/j.athoracsur.2009.08.056","article-title":"A new endoscopic technique for intraluminal repair of posterior tracheal laceration","volume":"90","author":"Welter","year":"2010","journal-title":"Ann Thorac Surg"},{"key":"B6","doi-asserted-by":"publisher","first-page":"119","DOI":"10.4081\/monaldi.2008.389","article-title":"Treatment of iatrogenic and traumatic tracheal disruptions","volume":"69","author":"Leoncinii","year":"2008","journal-title":"Monaldi Archives for Chest Disease=Archivio Monaldi per le Malattie del Torace"},{"key":"B7","doi-asserted-by":"publisher","first-page":"1837","DOI":"10.1016\/s0003-4975(98)00312-9","article-title":"Tracheobronchial laceration after double-lumen intubation for thoracic procedures","volume":"65","author":"Spaggiari","year":"1998","journal-title":"Ann Thorac Surg"},{"key":"B8","doi-asserted-by":"publisher","first-page":"424","DOI":"10.1016\/j.ejcts.2010.05.041","article-title":"Postintubation tracheal injuries: which criteria to guide non-surgical treatment?","volume":"39","author":"Leoncini","year":"2011","journal-title":"Eur J Cardio-Thorac Surg"},{"key":"B9","doi-asserted-by":"publisher","first-page":"216","DOI":"10.1016\/s0003-4975(99)01129-7","article-title":"Conservative treatment for postintubation tracheobronchial rupture","volume":"69","author":"Jougon","year":"2000","journal-title":"Ann Thorac Surg"},{"key":"B10","doi-asserted-by":"publisher","first-page":"412","DOI":"10.1378\/chest.130.2.412","article-title":"Management of postintubation tracheobronchial ruptures","volume":"130","author":"Conti","year":"2006","journal-title":"Chest"},{"key":"B11","doi-asserted-by":"publisher","first-page":"581","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 Cardio-Thorac Surg"},{"key":"B12","doi-asserted-by":"publisher","first-page":"698","DOI":"10.1097\/00000542-198512000-00026","article-title":"Tracheal rupture following the insertion of a disposable double-lumen endotracheal tube","volume":"63","author":"Wagner","year":"1985","journal-title":"Anesthesiol"},{"key":"B13","doi-asserted-by":"publisher","first-page":"369","DOI":"10.1097\/01.TA.0000031940.95165.FE","article-title":"Iatrogenic tracheal rupture: a novel approach to repair and a review of the literature","volume":"54","author":"Satyadas","year":"2003","journal-title":"J Trauma"},{"key":"B14","doi-asserted-by":"publisher","first-page":"218","DOI":"10.1159\/000455859","article-title":"Conservative versus surgical management of iatrogenic tracheal rupture. Medical principles and practice: international journal of the Kuwait university","volume":"26","author":"Panagiotopoulos","year":"2017","journal-title":"Health Sci Centre"},{"key":"B15","doi-asserted-by":"publisher","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":"B16","first-page":"42","article-title":"Weichteilverletzungen an kehlkopf bel notfallmaessigner intubation","volume":"29","author":"Maxeiner","year":"1988","journal-title":"Anaesth Intensivmed"},{"key":"B17","doi-asserted-by":"publisher","first-page":"399","DOI":"10.1016\/s1010-7940(01)00798-9","article-title":"Indications for surgery in tracheobronchial ruptures","volume":"20","author":"Gabor","year":"2001","journal-title":"Eur J Cardio-Thorac Surg"},{"key":"B18","doi-asserted-by":"publisher","first-page":"1056","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 Cardio-Thorac Surg"},{"key":"B19","doi-asserted-by":"publisher","first-page":"1622","DOI":"10.1007\/s00134-010-1906-5","article-title":"Conservative management of postintubation tracheal membrane ruptures","volume":"36","author":"Conti","year":"2010","journal-title":"Intensive Care Med"},{"key":"B20","doi-asserted-by":"publisher","first-page":"401","DOI":"10.1016\/j.icvts.2004.02.016","article-title":"Tracheobronchial injuries. Conservative treatment","volume":"3","author":"Lampl","year":"2004","journal-title":"Interact Cardiovasc Thorac Surg"},{"key":"B21","doi-asserted-by":"publisher","first-page":"1872","DOI":"10.1016\/j.athoracsur.2004.10.006","article-title":"Successful conservative management in iatrogenic tracheobronchial injury","volume":"79","author":"G\u00f3mez-Caro Andr\u00e9s","year":"2005","journal-title":"Ann Thorac Surg"},{"key":"B22","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1055\/s-2005-865917","article-title":"Tracheal rupture after endotracheal intubation: experience with management in 13 cases","volume":"54","author":"Sippel","year":"2006","journal-title":"Thorac Cardiovasc Surg"},{"key":"B23","doi-asserted-by":"publisher","first-page":"2568","DOI":"10.1007\/s00268-011-1227-z","article-title":"Conservative and surgical treatment of acute posttraumatic tracheobronchial injuries","volume":"35","author":"Carretta","year":"2011","journal-title":"World J Surg"},{"key":"B24","doi-asserted-by":"publisher","first-page":"434","DOI":"10.1378\/chest.128.1.434","article-title":"A 63-year-old woman with subcutaneous emphysema following endotracheal intubation","volume":"128","author":"Hashem","year":"2005","journal-title":"Chest"},{"key":"B25","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1177\/1089253216647488","article-title":"Assessment and management of post-intubation airway injuries","volume":"21","author":"Jones","year":"2017","journal-title":"Semin Cardiothorac Vasc Anesth"},{"key":"B26","doi-asserted-by":"publisher","first-page":"e45","DOI":"10.1016\/j.athoracsur.2018.10.070","article-title":"Video-Assisted thoracic surgical repair of the airway","volume":"108","author":"Mart\u00ednez-Hern\u00e1ndez","year":"2019","journal-title":"Ann Thorac Surg"},{"key":"B27","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1097\/00000539-200111000-00047","article-title":"A case of tracheal injury after emergent endotracheal intubation: a review of the literature and causalities","volume":"93","author":"Chen","year":"2001","journal-title":"Anesth Analg"},{"key":"B28","doi-asserted-by":"publisher","first-page":"809","DOI":"10.1590\/s1806-37132009000800014","article-title":"Post-intubation tracheal injury: report of three cases and literature review","volume":"35","author":"Medina","year":"2009","journal-title":"Jornal Bras Pneumol"},{"key":"B29","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1590\/s1808-86942012000100008","article-title":"Influence of sealant fibrin on the wound healing of the pigs vocal folds","volume":"78","author":"Portes","year":"2012","journal-title":"Braz J Otorhinolaryngol"},{"key":"B30","doi-asserted-by":"publisher","first-page":"979","DOI":"10.1097\/TA.0000000000001233","article-title":"Bronchoscopic management of iatrogenic tracheal laceration using polyurethane-covered nitinol tracheal stents","volume":"81","author":"Hussein","year":"2016","journal-title":"J Trauma Acute Care Surg"},{"key":"B31","doi-asserted-by":"publisher","first-page":"e11","DOI":"10.1016\/j.athoracsur.2015.12.030","article-title":"Successful treatment of an iatrogenic tracheal laceration with a temporary polyurethane-coated nitinol stent","volume":"102","author":"Lee","year":"2016","journal-title":"Ann Thorac Surg"},{"key":"B32","doi-asserted-by":"publisher","first-page":"1001","DOI":"10.1016\/j.athoracsur.2011.12.080","article-title":"Tracheal stent to repair tracheal laceration after a double-lumen intubation","volume":"94","author":"Marchese","year":"2012","journal-title":"Ann Thorac Surg"},{"key":"B33","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":"B34","doi-asserted-by":"publisher","first-page":"4772","DOI":"10.21037\/jtd.2019.10.22","article-title":"Does less surgical trauma result in better outcome in management of iatrogenic tracheobronchial laceration?","volume":"11","author":"Herrmann","year":"2019","journal-title":"J Thorac Dis"},{"key":"B35","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"},{"key":"B36","doi-asserted-by":"publisher","first-page":"102","DOI":"10.21037\/jovs.2017.06.12","article-title":"Endoscopic treatment with fibrin glue of post-intubation tracheal laceration","volume":"3","author":"Fiorelli","year":"2017","journal-title":"J Vis Surg"}],"container-title":["Frontiers in Surgery"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2022.1049126\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,11,23]],"date-time":"2022-11-23T01:06:50Z","timestamp":1669165610000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2022.1049126\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,11,23]]},"references-count":36,"alternative-id":["10.3389\/fsurg.2022.1049126"],"URL":"https:\/\/doi.org\/10.3389\/fsurg.2022.1049126","relation":{},"ISSN":["2296-875X"],"issn-type":[{"value":"2296-875X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,11,23]]},"article-number":"1049126"}}