A combination of tracheoplasty and tracheal stenting is an acceptable method of treating severe congenital tracheobronchial stenosis under extracorporeal membrane oxygenation

Congenital tracheobronchial stenosis (CTBS) is a rare congenital condition characterized by complete cartilage rings covering varying lengths of the major airway. In this study, we reviewed the outcomes of patients with CTBS receiving surgical tracheoplasty in our institute. We retrospectively analy...

Full description

Saved in:
Bibliographic Details
Published in:Journal of pediatric surgery 2019-12, Vol.54 (12), p.2492-2497
Main Authors: Yeh, Yi-Ting, Liu, Chinsu, Tsai, Hsin-Lin, Wu, Fei-Yi, Soong, Wen-Jue, Lee, Yu-Sheng, Tsao, Pei-Chen
Format: Article
Language:English
Subjects:
Airway stenting
Bronchi - abnormalities
Bronchi - surgery
Bronchial Diseases - surgery
Child, Preschool
Constriction, Pathologic - surgery
Dilatation
ECMO
Extracorporeal Membrane Oxygenation
Female
Hemochromatosis
Humans
Infant
Male
Reconstructive Surgical Procedures - methods
Retrospective Studies
Stents
Trachea - surgery
Tracheal Stenosis - surgery
Tracheobronchial stenosis
Tracheoplasty
Treatment Outcome
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Congenital tracheobronchial stenosis (CTBS) is a rare congenital condition characterized by complete cartilage rings covering varying lengths of the major airway. In this study, we reviewed the outcomes of patients with CTBS receiving surgical tracheoplasty in our institute. We retrospectively analyzed the outcomes of consecutive patients with CTBS operated between 2006 and 2017 when extracorporeal membrane oxygenation (ECMO) was used perioperatively. In total, 11 patients (median follow-up period, 4.2 years; interquartile range, 1.6–5.4) were included. Seven were symptomatic in the neonatal period, 10 had cardiorespiratory anomalies, 7 required preoperative bronchoscopic balloon dilatation, and 1 required preoperative stent placement. Slide tracheoplasty (STP) was performed in 9 patients, and 2 underwent pericardial patch tracheoplasty. Seven patients required postoperative balloon dilatation, and 6 required postoperative stent placement. Early stenting provided immediate ventilatory improvement in all patients and facilitated successful extubation in a median of 4 days after stenting in 80% of the patients. Under ECMO, severe CTBS could be successfully treated through a combination of tracheoplasty and bronchoscopic management. STP provided excellent results for solitary trachea stenosis with a minimum diameter of ≥3 mm. In selected patients, postoperative tracheobronchial stent placement was crucial in minimizing the ECMO duration and facilitating extubation. IV
ISSN:0022-3468
1531-5037
DOI:10.1016/j.jpedsurg.2019.08.043