Related Experiment Video

Updated: Sep 9, 2025

Low-Cost Single-Port LoCoSP Device for a Transcervical Approach in Minimally Invasive Transhiatal Esophagectomy
09:04

Low-Cost Single-Port LoCoSP Device for a Transcervical Approach in Minimally Invasive Transhiatal Esophagectomy

Published on: September 11, 2021

3.0K

Primary posterior tracheopexy in esophageal atresia with tracheomalacia: From innovation to multicenter RCT

Mya Lindeboom1, Ajn Bittermann1, Shaj Tytgat1

  • 1Department of Pediatric Surgery, Congenital Esophageal and Airway Team, Wilhelmina Children's Hospital, University Medical Center Utrecht, the Netherlands.

Journal of Pediatric Surgery
|August 30, 2025
PubMed

Insights

Primary posterior tracheopexy (PPT) in esophageal atresia (EA) patients may reduce respiratory infections and healthcare costs. Further research via the PORTRAIT trial will determine if PPT should become standard treatment.

Area of Science:

  • Pediatric Surgery
  • Thoracic Surgery
  • Neonatal Medicine

Background:

  • Tracheomalacia (TM) is a frequent comorbidity in children with esophageal atresia (EA), affecting up to 87% of patients.
  • Severe TM can lead to significant respiratory morbidity, often necessitating surgical intervention.
  • Surgical approaches have evolved from secondary procedures to primary posterior tracheopexy (PPT).

Purpose of the Study:

  • To describe the evolution of surgical treatment for TM in EA patients.
  • To evaluate the efficacy and outcomes of primary posterior tracheopexy (PPT) in a single-center cohort.
  • To establish a framework for further research and clinical trials.

Main Methods:

  • A single-center cohort study of 38 EA patients, with 14 undergoing PPT.
  • Comparison of PPT outcomes with historical controls.
  • Analysis of respiratory morbidity, including brief resolved unexplained events and infections.
  • Cost analysis focusing on respiratory-related admissions.

Main Results:

  • PPT was associated with a trend towards reduced brief resolved unexplained events (39% vs. 19%, p=0.09).
  • PPT significantly decreased respiratory infections compared to historical controls (61% vs. 25%, p=0.004).
  • Cost analysis indicated lower respiratory-related admissions post-PPT, excluding outliers.

Conclusions:

  • Early findings suggest PPT effectively reduces respiratory morbidity in EA patients with TM.
  • PPT may offer potential healthcare cost savings by lowering respiratory-related admissions.
  • The PORTRAIT trial is designed to provide high-level evidence on PPT's role in standard EA repair.
Abstract

Keywords:
Esophageal atresiaPrimary posterior tracheopexyTracheomalacia

More Related Videos

Endotracheal Intubation via Tracheotomy and Subsequent Thoracotomy in Rats for Non-Survival Applications04:43

Endotracheal Intubation via Tracheotomy and Subsequent Thoracotomy in Rats for Non-Survival Applications

Published on: March 15, 2024

749
Heterotopic and Orthotopic Tracheal Transplantation in Mice used as Models to Study the Development of Obliterative Airway Disease09:10

Heterotopic and Orthotopic Tracheal Transplantation in Mice used as Models to Study the Development of Obliterative Airway Disease

Published on: January 20, 2010

14.0K

Related Concept Videos

Trachea01:22

Trachea

The trachea, commonly known as the windpipe, is a vital part of the human respiratory system. It serves as a passageway for air to travel between the larynx and the bronchi, allowing oxygen to reach the lungs. Let's explore its anatomical features, dimensions, layers of the tracheal wall, associated muscles, and the functions of its parts.
Anatomical Features:
Location: About half of the trachea is situated in the neck, anterior to the esophagus, and extends from the larynx (at the level of...
2.7K
Cardiopulmonary Resuscitation V: Advanced Airway Management Techniques01:30

Cardiopulmonary Resuscitation V: Advanced Airway Management Techniques

Airway management is essential in emergency and surgical medicine, ensuring ventilation and oxygenation in patients who cannot maintain their own airway. Clinicians use a range of techniques and devices to secure the airway, depending on the patient’s condition and the clinical context. Key methods include endotracheal intubation, rapid sequence intubation (RSI), supraglottic airway devices, and advanced visualization aids. In cases where these approaches fail, surgical airway...
77
Oxygen Delivering System III: Tracheostomy and T-piece01:23

Oxygen Delivering System III: Tracheostomy and T-piece

Oxygen delivery is critical in clinical care, especially for patients with respiratory disorders or those undergoing surgical procedures. Various systems, such as tracheostomy and the T-piece, deliver oxygen to the lungs, ensuring adequate arterial oxygenation.
Tracheostomy
A tracheostomy is a surgically created opening (stoma) in the anterior part of the trachea. It is used to establish a patient airway, bypass an upper airway obstruction, simplify the removal of secretions, permit long-term...
2.3K
Tracheostomy: Procedure and Tubes01:28

Tracheostomy: Procedure and Tubes

A tracheostomy is a surgical procedure that creates an artificial opening into the trachea, typically at the second or third cartilaginous ring level. This opening allows the insertion of a tracheostomy tube, which can replace an endotracheal tube, provide mechanical ventilation, bypass an upper airway obstruction, or remove accumulated tracheobronchial secretions.
Tracheostomy tubes can be made of semiflexible plastic (polyurethane or silicone), rigid plastic, or metal, and they come in...
1.2K
Esophageal Strictures-II: Clinical Features and Management01:26

Esophageal Strictures-II: Clinical Features and Management

Patients with esophageal strictures often experience a range of symptoms. Initially, they may have difficulty swallowing solid foods, which can progress to include liquids. Additional symptoms may involve chest pain or discomfort, regurgitating food and fluids, heartburn, unintentional weight loss, coughing or choking during meals, and hoarseness.
Healthcare providers should gather a comprehensive medical history and conduct a physical examination for diagnosis. If esophageal stricture is...
156
Tracheostomy Care II: Procedure01:25

Tracheostomy Care II: Procedure

Tracheostomy care is an essential nursing skill that involves cleaning and maintaining a tracheostomy tube to prevent infection and other complications. Here's a step-by-step guide explaining each procedure with its rationale. Note that disposable gloves are to be worn at all times and changed as often as needed to maintain a sterile work environment, and to protect both patient and healthcare worker.
Step 1: Perform hand hygiene, and put on personal protective equipment: gown, gloves, mask...
430