Management and outcome of bronchial trauma due to blunt versus penetrating injuries

Table 1 Surgical procedures and outcomes in 73 patients

Surgical procedure	No. of patients	No. of survivors
BBT group (n = 38)
Debridement and end-to-end anastomosis of the main bronchus	121,2	12
Simple suture of the main bronchus	3	3
EDT for clamping of proximal end of main bronchus	1	0
Emergency explorative thoracotomy in operating room	1	0
Pneumonectomy of left lung	1	0
Simple suture of lobar bronchus	5	5
Lobectomy	73	7
Irregular segmentectomy	8	8
PBT group (n = 35)
Repair of main bronchus	21	2
Simple suture of lobar bronchus	4	4
Lobectomy	6	6
Emergency explorative thoracotomy in operating room	1	0
Pulmonary tractotomy for ligation of vessels and bronchi	22	21

¹Simultaneous repair of vascular injury in one case.

²Two required reoperation, including resection of the stenosed segment followed by anastomosis 3 years later in one and sleeve resection with the upper lobe 6 mo later in another.

³In one of seven patients, anastomosis was performed during the initial thoracotomy, and reoperation had to be performed because of stenosis 3 mo later.

BBT: Blunt bronchial trauma; PBT: Penetrating bronchial trauma; EDT: Emergency department thoracotomy.

Table 2 Comparisons of variables between the two groups (blunt and penetrating)

Variable	Blunt (n = 38)	Penetrating (n = 35)	P value
Mean ISS	38.22 ± 8.13	21.33 ± 6.12	< 0.001
Incidence of polytrauma	31/38 (81.6%)	8/35 (22.9%)	< 0.001
Incidence of BT	38/1911 (2.0%)	35/1107 (3.2%)	< 0.05
Injured right side	22/38 (57.9%)	10/35 (28.6%)	< 0.001
Time of definite diagnosis after injury > 48 h	21/38 (55.3%)	0/35 (0.0%)	< 0.001
Preoperative imaging	35/38 (92.1%)	12/35 (34.3%)	< 0.001
Incidence of partial resection of lung	16/38 (42.1%)	6/35 (17.1%)	< 0.025
Percentage of segmental bronchus injury	8/38 (21.1%)	22/35 (62.9%)	< 0.001
Shock rate	12/38 (31.6%)	31/35 (88.6%)	< 0.001
Morbidity	8/38 (21.1%)	0/35 (0%)	< 0.001
Mortality	3/38 (7.9%)	2/35 (5.7%)	> 0.05

ISS: Injury severity score; BT: Bronchial trauma.