Der Chirurg; Zeitschrift für alle Gebiete der operativen Medizen
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In trauma patients with chest injuries, serial rib fractures and intrathoracic lacerations, the indication for primary thoracotomy is usually limited to life-threatening organ ruptures. In our own experience with 13 patients, primary thoracotomy offers the chance of immediate closure of lung lacerations, suture of pleural and pericardial tears, ligature of torn intercostal vessels, and stabilization of the chest wall by rib plating. ⋯ Complications and duration of respirator treatment can be reduced. This will reduce the high lethality rates of chest injuries significantly.
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Primary resection of the trachea and direct anastomosis is indicated whenever inflammatory stenoses and tumors of the trachea are present. In our own series of 27 patients operated upon there were 17 stenoses by scars, two malacias of the trachea, six adenoid-cystic carcinomas, one adenoma of the bronchus and one chondroma. One patient died on the 16th postoperative day from stress-ulcer bleeding. ⋯ Data on the late results are given. New reports in the literature and our own experience indicate that a tracheal resection with a direct anastomosis seems to be a standardized procedure. Using the right indication for the operation good early and late results can be achieved.