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Surgical management of suprastomal tracheal collapse in children
Ali Tawfik1, Hisham Atef Ebada1, Ahmed Musaad Abd El-Fattah1
1Mansoura University, Egypt.
Insights
A surgical technique effectively manages pediatric suprastomal collapse, a complication of tracheotomy, leading to successful decannulation. This simple procedure offers a low-morbidity solution for improved quality of life in children.
Area of Science:
- Pediatric surgery
- Otolaryngology
- Respiratory medicine
Background:
- Suprastomal collapse is a significant complication following pediatric tracheotomy.
- It can negatively impact the success rate of decannulation.
- Effective management strategies are crucial for patient outcomes.
Purpose of the Study:
- To review the management of pediatric suprastomal collapse at a tertiary care center.
- To detail the surgical technique used for treating this condition.
- To evaluate the efficacy and safety of the surgical approach.
Main Methods:
- A retrospective review of 12 pediatric patients with suprastomal collapse over 5 years.
- Surgical intervention involved dissecting the tracheotomy tract and excising it flush with the anterior tracheal wall.
- Tracheal closure was performed transversely using interrupted absorbable sutures.
Main Results:
- All 12 patients were successfully decannulated post-surgery.
- No intraoperative complications occurred.
- Minor postoperative complications (surgical emphysema, wound infection) in 3 patients were managed conservatively.
Conclusions:
- The described surgical technique is simple and effective for pediatric suprastomal collapse.
- It facilitates immediate decannulation with minimal morbidity.
- Long-term follow-up showed no recurrence, with patients returning to their normal quality of life.
Objective:
Suprastomal collapse is a complication of pediatric tracheotomy with a potential impact on decannulation success. The aim of this study was to review the experience in the management of pediatric suprastomal collapse in a tertiary-care center, detailing the surgical technique employed.
Methods:
This study included 12 tracheotomised children with the diagnosis of suprastomal collapse in the last 5 years. All patients of the study underwent surgical intervention to manage suprastomal collapse to achieve tracheotomy decannulation. The surgical procedure entailed dissection of the pre-existing tracheotomy tract down to the trachea, then excision of the tract flush with the anterior tracheal wall. The tracheal opening was closed transversely with 3-4 interrupted absorbable sutures placed in craniocaudal direction.
Results:
At the end of treatment all patients were decannulated successfully. No intraoperative complications were reported. Minor postoperative complications were reported in 3 children in the form of mild surgical emphysema (n = 2) and wound infection (n = 1). Those patients were successfully managed conservatively.
Conclusion:
This technique is a simple and effective procedure enabling immediate decannulation with very low morbidity. In a long term follow up period, no recurrence has been reported and all patients returned to their usual quality of life.
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