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Thoracoscopic aortopexy for symptomatic tracheobronchomalacia
Zeng Hao Wong1, Richard Hewitt2, Kate Cross3
1Specialist Neonatal and Paediatric Surgery, Great Ormond Street Hospital, Paediatric Surgery, London, United Kingdom; Paediatric Surgery, Mount Alvernia Hospital, Singapore.
Thoracoscopic aortopexy is an effective treatment for symptomatic tracheobronchomalacia, with 81% of patients experiencing symptom resolution. Tracheobronchomalacia involving the bronchi may increase the risk of needing a tracheostomy.
Area of Science:
- Pediatric Surgery
- Thoracic Surgery
- Respiratory Medicine
Background:
- Symptomatic tracheobronchomalacia can be life-threatening.
- Aortopexy is a successful treatment for this condition.
- The thoracoscopic approach offers a minimally invasive option.
Purpose of the Study:
- To evaluate the outcomes of thoracoscopic aortopexy for tracheobronchomalacia.
- To identify risk factors for subsequent tracheostomy.
Main Methods:
- Retrospective review of patients undergoing thoracoscopic aortopexies (2009-2018).
- Analysis of patient demographics, comorbidities, and operative details.
- Logistic regression used to identify risk factors for tracheostomy (p < 0.05).
Main Results:
- Twenty-one patients with tracheomalacia (17 mid/distal, 4 bronchial involvement) were treated.
- Indications included life-threatening events, recurrent infections, and ventilation weaning failure.
- 81% of patients achieved symptom resolution; 2 required tracheostomy, with tracheobronchomalacia nearing significance as a risk factor.
Conclusions:
- Thoracoscopic aortopexy is effective in treating tracheobronchomalacia.
- Diagnostic modalities like bronchoscopy, tracheobronchogram, and CT are crucial.
- Tracheobronchomalacia with bronchial involvement may be a risk factor for tracheostomy.
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