External stabilization for severe tracheobronchomalacia using separated ring-reinforced ePTFE grafts is effective and safe on a long-term basis.

Abstract

PURPOSE:

Tracheobronchomalacia is a respiratory disorder that results from abnormal cartilage development. Since 2003, we have performed external stabilization for severe tracheobronchomalacia using separated ring-reinforced expanded polytetrafluoroethylene (ePTFE) grafts. The aim of this study was to analyze the short- and long-term outcomes of our procedure.

METHODS:

We reviewed the charts of patients who underwent external tracheobronchial stabilization from January 2003 through December 2012. Separated ring-reinforced ePTFE grafts were fixed to the anterior and posterior lesions of malacia independently, with confirmation of a well-opened lumen by bronchoscopy.

RESULTS:

Five children with severe tracheobronchomalacia underwent six operations. The median follow-up period was 43 months (range 11-109 months). There was no operative mortality associated with the procedure. One patient required removal of a section of the graft owing to the development of bronchial granulation tissue at the site of fixation. All patients showed improved respiratory function, and tracheal growth was confirmed by follow-up computed tomography.

CONCLUSIONS:

External stabilization with separated ring-reinforced ePTFE grafts for severe tracheobronchomalacia is effective, less invasive than alternatives and preserves the growth potential of the affected airway segment.

• Authors: Shinya Takazawa, Hiroo Uchida, Hiroshi Kawashima, Yujiro Tanaka, Takayuki Masuko, Kyoichi Deie, Yuzo Nagase, Tadashi Iwanaka
• Journal: Pediatric surgery international (Pediatr Surg Int) Vol. 29 Issue 11 Pg. 1165-9 (Nov 2013) ISSN: 1437-9813 [Electronic] Germany
• PMID: 23982386 (Publication Type: Journal Article)

Chemical References

• Polytetrafluoroethylene

Topics

• Bronchi (surgery)
• Bronchoscopy
• Female
• Follow-Up Studies
• Humans
• Infant
• Male
• Polytetrafluoroethylene
• Prostheses and Implants
• Prosthesis Design
• Plastic Surgery Procedures (methods)
• Retrospective Studies
• Severity of Illness Index
• Suture Techniques
• Time Factors
• Tomography, X-Ray Computed
• Trachea (surgery)
• Tracheobronchomalacia (diagnosis, surgery)
• Treatment Outcome