Thoracoscopic Posterior Tracheopexy Is a Feasible and Effective Treatment for Tracheomalacia

Dewberry, Lindel C.; Wine, Todd; Prager, Jeremy D.; Masaracchia, Melissa M.; Janosy, Norah; Polaner, David M.; DeBoer, Emily M.; Sømme, Stig

doi:10.1089/lap.2019.0156

Cited by 14 publications

(15 citation statements)

References 13 publications

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“…Given the high proportion of abnormalities, CTA with volumetric inspiratory and dynamic expiratory imaging of the trachea is beneficial to understand pulmonary comorbidities as an adjunct to airway bronchoscopy. Furthermore, in patients with more severe symptoms, respiratory‐related hospital admissions, or other significant comorbidities, the assessment of tracheomalacia and vascular compression may aid in decision making regarding aortopexy and/or tracheopexy 1,9,10,14,15 …”

Section: Discussionmentioning

confidence: 99%

“…A prior case series of echocardiogram and upper gastrointestinal imaging findings in this population reports frequent vascular compression on the tracheobronchial tree, indicating potential abnormal breathing dynamics and airway clearance in those with EA ± TEF 7,8 . Knowledge of vascular compression and tracheomalacia is important given that in addition to medical management of any pulmonary symptoms, surgical interventions such as aortopexy (lifting the aorta off the bronchial tree) and tracheopexy (pinning the posterior trachea in place to prevent excessive collapse) are potential treatments to relieve significant airway compression and dynamic tracheomalacia 9,10 …”

Section: Introductionmentioning

confidence: 90%

“…7,8 Knowledge of vascular compression and tracheomalacia is important given that in addition to medical management of any pulmonary symptoms, surgical interventions such as aortopexy (lifting the aorta off the bronchial tree) and tracheopexy (pinning the posterior trachea in place to prevent excessive collapse) are potential treatments to relieve significant airway compression and dynamic tracheomalacia. 9,10 There are limited reports of computed tomography (CT) and computed tomography angiography (CTA) testing to identify the vascular and pulmonary anatomy of children after EA ± TEF repair. 6 On the basis of our clinical experience, we hypothesize that many of these children with chronic respiratory symptoms have vascular airway compression in addition to tracheomalacia.…”

Section: Introductionmentioning

confidence: 99%

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Vascular and pulmonary comorbidities in children with congenital EA/TEF

Poore

Weinman

Handley

et al. 2020

Pediatric Pulmonology

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 90%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Vascular and pulmonary comorbidities in children with congenital EA/TEF

Poore

Weinman

Handley

et al. 2020

Pediatric Pulmonology

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“…In the last few years, other approaches have been proposed to treat tracheobronchomalacia. In 2017 PT was first described by Boston group [1]; since then, other publications have described this approach [2,7,8]. Despite other reports about PT were published later, very few groups in the world have adopted PT, probably considering it a technically challenging approach.…”

Section: Discussionmentioning

confidence: 99%

“…The two procedures can be associated in the same patients. Open, thoracoscopic and robotic PT have been described [1][2][3], but the technique is relatively new and it has been adopted in very few Centers. Our aims are to discuss technical surgical details based on our preliminary experience of thoracoscopic and robotic PT and to evaluate if this new approach could be proposed widely as a valuable tool for treating surgically TBM.…”

Section: Introductionmentioning

confidence: 99%

Posterior tracheobrochopexy with thoracoscopic or robotic approach: technical details

et al. 2020

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Purpose Posterior tracheopexy has been proposed as a novel approach to treat tracheobronchomalacia, in addition or alternative to more traditional treatments as aortopexy. Reports on this technique are still very sporadic. Our aim is to discuss technical surgical details based on our preliminary experience of thoracoscopic and robotic posterior tracheopexy. Methods Technical details on 6 patients (from 8 months to 13 years of age) operated for posterior tracheopexy with a thoracoscopic approach are presented and discussed. In two cases robotic posterior tracheopexy was performed. Results Two patients presented multiple comorbidities and had a tracheostomy previously performed. Airway obstruction evaluated at pre-operative bronchoscopy was between 70 and 100%, with posterior intrusion of pars membranacea. Operative time ranged from 110 to 320 min. In three cases aortopexy was associated, one at the same time, in the other two before or after tracheopexy. No specific complications of posterior tracheopexy were observed. Robotic approach made the esophageal dissection and the tracheobronchopexy technically easier. Conclusion Thoracoscopic approach is feasible, robotic assistance is helpful for improving visualization, esophageal dissection, and making easier and more precise the pexy of the trachea and bronchi on all its length. Both bronchi can be approached and pexied if necessary, and this is a specific advantage of tracheopexy with respect to aortopexy. Intraoperative bronchoscopy and strict collaboration between surgeons and anesthesiologists are essential.

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Posterior tracheopexy for preterm infants with severe bronchopulmonary dysplasia and severe tracheobronchomalacia: A case series

Enzer

Wine

Gien

et al. 2022

Pediatric Pulmonology

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We report a series of four patients with severe bronchopulmonary dysplasia (BPD) who underwent posterior tracheopexy for severe tracheomalacia (TM). While posterior tracheopexy is an established surgical treatment for TM associated with tracheoesophageal fistula, it has not been previously described in TM associated with BPD. There were no significant intraoperative or postoperative complications from the surgeries. Three of the four patients required tracheostomy and mechanical ventilation, which may reflect the degree of lung disease and other multisystem comorbidities in these patients. More investigation is needed to determine whether posterior tracheopexy is an effective surgical option for TM related to BPD.

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Thoracoscopic Posterior Tracheopexy Is a Feasible and Effective Treatment for Tracheomalacia

Cited by 14 publications

References 13 publications

Vascular and pulmonary comorbidities in children with congenital EA/TEF

Vascular and pulmonary comorbidities in children with congenital EA/TEF

Posterior tracheobrochopexy with thoracoscopic or robotic approach: technical details

Posterior tracheopexy for preterm infants with severe bronchopulmonary dysplasia and severe tracheobronchomalacia: A case series

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