Long-term outcomes of four patients with tracheal agenesis who underwent airway and esophageal reconstruction

• Published in: Journal of pediatric surgery 2015-12, Vol.50 (12), p.2009-2011
• Main Authors: Tazuke, Yuko, Okuyama, Hiroomi, Uehara, Shuichiro, Ueno, Takehisa, Nara, Keigo, Yamanaka, Hiroaki, Kawahara, Hisayoshi, Kubota, Akio, Usui, Noriaki, Soh, Hideki, Nomura, Motonari, Oue, Takaharu, Sasaki, Takashi, Nose, Satoko, Saka, Ryuta
• Format: Article
• Language: English
• Subjects: Child; Child, Preschool; Constriction, Pathologic - surgery; Esophagus - surgery; Female; Follow-Up Studies; Humans; Long-term outcomes; Male; Pediatrics; Prognosis; Reconstruction; Reconstructive Surgical Procedures - methods; Retrospective Studies; Surgery; Trachea - abnormalities; Trachea - surgery; Tracheal agenesis; Treatment Outcome
• ISSN: 0022-3468; 1531-5037
• DOI: 10.1016/j.jpedsurg.2015.08.014

Abstract Purpose The aim of this study was to evaluate the long-term outcomes of four patients with tracheal agenesis who underwent airway and esophageal/alimentary reconstruction. Materials and Methods We reviewed the medical records of four long-term survivors of tracheal agenesis and collected the following data: age, sex, type of tracheal agenesis, method of reconstruction, nutritional management, and physical and neurological development. Results The patients consisted of three boys and one girl, who ranged in age from 77 to 109 months. The severity of their condition was classified as Floyd's type I ( n = 2), II ( n = 1), or III ( n = 1). Mechanical respiratory support was not necessary in any of the cases. Esophageal/alimentary reconstruction was performed using the small intestine ( n = 2), a gastric tube ( n = 1), and the esophagus ( n = 1). The age at esophageal reconstruction ranged from 41 to 55 months. All of the cases required enteral nutrition via gastrostomy. Three of the patients were able to swallow a small amount of liquid and one was able to take pureed food orally. The physical development of the subjects was moderately delayed–borderline in childhood. Neurological development was normal in two cases and slightly delayed in two cases. Conclusions None of the long-term survivors of tracheal agenesis required the use of an artificial respirator, and their development was close to normal. Future studies should aim to elucidate the optimal method for performing esophageal reconstruction to allow tracheal agenesis patients to achieve their full oral intake.