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Severe tracheomalacia associated with esophageal atresia: results of surgical treatment.

Abstract：

:This study reviews our experience from 1977 to 1991 with 32 children born with esophageal atresia and tracheoesophageal fistula (EA-TEF) who later underwent surgery for severe tracheomalacia. Indications for surgery included dying spells (21), inability to extubate the airway (nasotracheal tube 5, tracheotomy 3), and recurrent pneumonia (3). Diagnosis was confirmed by chest x-ray, esophagogram, and bronchoscopy. Aortopexy was performed in 31 of 32 children; a splint without aortopexy was used in one older girl. Splinting was also necessary in two of the 31 at the initial operation, when aortopexy failed to prevent tracheal collapse. There were four initial failures. Currently, 29 children are well (median follow-up, 6.6 years). Two have a tracheostomy in place, and one, who had a vascular ring divided after aortopexy, died at home of unknown cause 1 month later. These findings indicate that aortopexy provides long-term relief of severe symptoms of tracheomalacia associated with EA-TEF in almost all affected children. When aortopexy fails, the insertion of an airway splint may succeed; otherwise, tracheostomy is necessary.

journal_name

J Pediatr Surg

journal_title

Journal of pediatric surgery

authors

Filler RM,Messineo A,Vinograd I

doi

10.1016/0022-3468(92)90575-r

subject

Has Abstract

pub_date

1992-08-01 00:00:00

pages

1136-40; discussion 1140-1

issue

8

eissn

0022-3468

issn

1531-5037

pii

0022-3468(92)90575-R

journal_volume

27

pub_type

杂志文章

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