Clinical Outcomes After Tracheobronchoplasty With Ringed Polytetrafluoroethylene Vascular Graft.

Area of Science:

• Thoracic surgery
• Pulmonary medicine
• Biomaterials in medicine

Background:

• Severe expiratory central airway collapse presents a significant clinical challenge.
• Tracheobronchoplasty (TBP) is a surgical option for managing airway collapse.
• The use of ringed polytetrafluoroethylene (PTFE) vascular grafts in TBP is explored.

Purpose of the Study:

• To describe the surgical technique of tracheobronchoplasty (TBP) utilizing a ringed polytetrafluoroethylene (PTFE) vascular graft.
• To evaluate the clinical outcomes and efficacy of PTFE-TBP in patients with severe expiratory central airway collapse.

Main Methods:

• Retrospective identification of 14 patients undergoing PTFE-TBP for severe expiratory central airway collapse (2018-2021).
• Outcomes assessed via St George's Respiratory Questionnaire (SGRQ), Cough-Specific Quality of Life Questionnaire (CSQLQ), pulmonary function tests, 6-minute walk test, and dynamic bronchoscopy.
• Blinded video analysis of bronchoscopy at 3-month follow-up evaluated airway collapsibility.

Main Results:

• PTFE-TBP demonstrated significant improvements in median SGRQ scores (14.79, P=.013) and CSQLQ scores (22, P=.005).
• Postoperative bronchoscopy revealed significant reductions in airway collapsibility across the trachea and main bronchi (30.7%-50%, P<.001).
• No significant differences were observed in pulmonary function tests or 6-minute walk tests; one patient experienced a Clavien-Dindo grade ≥3 complication.

Conclusions:

• Ringed polytetrafluoroethylene (PTFE) tracheobronchoplasty (TBP) effectively improves symptoms and reduces expiratory central airway collapse.
• The procedure shows significant benefits as indicated by quality of life improvements and objective bronchoscopic findings.
• PTFE-TBP represents a viable surgical strategy for selected patients with severe central airway collapse.