{"title":"Usefulness of lateral-anteroposterior dimeter ratio in patients with tracheomalacia associated with esophageal atresia.","authors":"Wataru Sumida, Takahisa Tainaka, Chiyoe Shirota, Satoshi Makita, Hizuru Amano, Akihiro Yasui, Takuya Maeda, Daiki Kato, Yosuke Goda, Hiroki Ishii, Kazuki Ota, Guo Yaohui, Liu Jiahui, Akinari Hinoki, Hiroo Uchida","doi":"10.1007/s00383-024-05877-9","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>Tracheomalacia (TM) is commonly associated with esophageal atresia (EA) and compression by the brachiocephalic artery is a factor for TM. Previous research has focused on the lateral-to-anteroposterior tracheal diameter ratio (LAR). This study aimed to assess the LAR and postoperative outcomes of EA patients.</p><p><strong>Methods: </strong>Patients undergoing thoracoscopic repair for EA between March 2020 and October 2023 were enrolled. Posterior tracheopexy (PT) was performed during thoracoscopic repair of EA on patients with bronchoscopy-confirmed TM; clinical courses and LAR were retrospectively analyzed.</p><p><strong>Results: </strong>Overall, 18 patients were enrolled; 14 patients underwent PT. Their median preoperative and postoperative LARs were 2.26 and 1.50, respectively; this difference was statistically significant. Four patients without TM did not undergo PT and their median LAR was 1.59. Median LAR for patients without PT was lower than that of preoperative patients with PT and no statistical differences were observed from that of postoperative patients with PT. The patients whose LAR improved with PT did not require further surgical intervention for TM. One patient who had a postoperative LAR of 2.25 required external tracheal stenting.</p><p><strong>Conclusion: </strong>LAR is a useful index for determining the severity of TM associated with EA. LAR can reflects the efficacy of PT.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"40 1","pages":"282"},"PeriodicalIF":1.5000,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Pediatric Surgery International","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00383-024-05877-9","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PEDIATRICS","Score":null,"Total":0}
引用次数: 0
Abstract
Purpose: Tracheomalacia (TM) is commonly associated with esophageal atresia (EA) and compression by the brachiocephalic artery is a factor for TM. Previous research has focused on the lateral-to-anteroposterior tracheal diameter ratio (LAR). This study aimed to assess the LAR and postoperative outcomes of EA patients.
Methods: Patients undergoing thoracoscopic repair for EA between March 2020 and October 2023 were enrolled. Posterior tracheopexy (PT) was performed during thoracoscopic repair of EA on patients with bronchoscopy-confirmed TM; clinical courses and LAR were retrospectively analyzed.
Results: Overall, 18 patients were enrolled; 14 patients underwent PT. Their median preoperative and postoperative LARs were 2.26 and 1.50, respectively; this difference was statistically significant. Four patients without TM did not undergo PT and their median LAR was 1.59. Median LAR for patients without PT was lower than that of preoperative patients with PT and no statistical differences were observed from that of postoperative patients with PT. The patients whose LAR improved with PT did not require further surgical intervention for TM. One patient who had a postoperative LAR of 2.25 required external tracheal stenting.
Conclusion: LAR is a useful index for determining the severity of TM associated with EA. LAR can reflects the efficacy of PT.
目的：气管畸形（TM）通常与食管闭锁（EA）有关，肱动脉的压迫是导致气管畸形的一个因素。以往的研究主要集中在气管外侧与前胸直径比值（LAR）上。本研究旨在评估 LAR 和 EA 患者的术后效果：纳入2020年3月至2023年10月期间接受胸腔镜修复术治疗EA的患者。在胸腔镜下修复 EA 期间，对支气管镜确诊为 TM 的患者进行了后气管切开术（PT）；对临床病程和 LAR 进行了回顾性分析：共有 18 名患者入选，其中 14 名患者接受了气管插管术。他们术前和术后的 LAR 中位数分别为 2.26 和 1.50，差异具有统计学意义。4 名没有 TM 的患者没有进行 PT，他们的中位 LAR 为 1.59。未进行 PT 的患者的 LAR 中位数低于术前进行 PT 的患者，与术后进行 PT 的患者的 LAR 中位数相比无统计学差异。经 PT 治疗后 LAR 得到改善的患者不需要进一步的 TM 手术治疗。一名术后 LAR 为 2.25 的患者需要外置气管支架：结论：LAR 是判断与 EA 相关的 TM 严重程度的有用指标。结论：LAR 是判断 EA 相关 TM 严重程度的有用指标，LAR 可以反映 PT 的疗效。
期刊介绍：
Pediatric Surgery International is a journal devoted to the publication of new and important information from the entire spectrum of pediatric surgery. The major purpose of the journal is to promote postgraduate training and further education in the surgery of infants and children.
The contents will include articles in clinical and experimental surgery, as well as related fields. One section of each issue is devoted to a special topic, with invited contributions from recognized authorities. Other sections will include:
-Review articles-
Original articles-
Technical innovations-
Letters to the editor
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