Abstract
Purpose:
Tracheomalacia (TM) with esophageal atresia (EA) is a common condition. Compression by brachiocephalic artery (BCA) is a factor of TM. Previous research focused on the lateral-to-anteroposterior tracheal diameter ratio (LAR) on computed tomography (CT). The current study examined the changes of LAR and the postoperative course by posterior tracheopexy (PT).
Methods:
This study included patients undergoing thoracoscopic repair for EA. PT was performed during thoracoscopic repair on patients with bronchoscopy-confirmed TM. The clinical courses and LAR were retrospectively analyzed.
Results:
In total, 14 of 18 patients with TM underwent PT. Six patients who underwent PT also underwent CT before and after surgery. Their median LAR improved from 2.26 to 1.50. Of the 14 patients who underwent PT, 8 were discharged without any respiratory support. Meanwhile, four patients were discharged with respiratory support and were successfully weaned within a year. Two patients required tracheostomy. Furthermore, one patient with tracheobronchomalacia who had a postoperative LAR of 2.25 subsequently required external tracheal stenting. Four patients without TM did not undergo PT. Their median LAR was 1.59, which was lower than the preoperative LAR of patients with TM.
Conclusion:
Aggressive PT significantly alleviates TM symptoms, and LAR is a direct severity indicator.