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A decade of using intraluminal tracheal/bronchial stents in the management of tracheomalacia and/or bronchomalacia: is it better than aortopexy?
- Source :
-
Journal of pediatric surgery [J Pediatr Surg] 2005 Jun; Vol. 40 (6), pp. 904-7; discussion 907. - Publication Year :
- 2005
-
Abstract
- Background: We compared the efficacy and clinical outcomes of aortopexy versus tracheal stents in the management of tracheomalacia.<br />Methods: A retrospective analysis of 25 consecutive patients undergoing aortopexy (n = 11; 8 boys, 3 girls) or tracheal stents (n = 14; 9 boys, 5 girls) between 1993 and 2003 was performed.<br />Results: Both treatment groups, aortopexy versus stents, were comparable in their mean age of diagnosis, timing of intervention, surgical indications ("dying spell" or failed extubation), and previous underlying conditions. The operative time (190 vs 72 minutes) and blood loss (26 vs 0 mL) were significantly greater in aortopexy group (P < .01). There were no perioperative deaths in either group. Interestingly, 4 of 11 patients in the aortopexy group developed pericardial effusion (P < .01). With stents in place for a mean of 15 (range 2-41) months, 3 of 8 patients with stent removal had significant granulation tissue requiring further dilatation. No death was observed in aortopexy group, whereas 1 stent-related death and 1 cardiac arrest requiring median sternotomy occurred during stent removal in 44 and 32 months' follow-up, respectively.<br />Conclusion: Both aortopexy and tracheal stents are effective treatment modalities in the management of tracheomalacia. However, although aortopexy is associated with early perioperative complications, tracheal stents are associated with higher failure rate and more severe stent-related morbidity and mortality.
- Subjects :
- Catheterization
Child, Preschool
Direct Service Costs
Female
Humans
Infant
Male
Postoperative Complications
Retrospective Studies
Thoracic Surgical Procedures economics
Thoracic Surgical Procedures methods
Aorta surgery
Bronchial Diseases therapy
Stents economics
Tracheal Diseases therapy
Tracheal Stenosis therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1531-5037
- Volume :
- 40
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Journal of pediatric surgery
- Publication Type :
- Academic Journal
- Accession number :
- 15991168
- Full Text :
- https://doi.org/10.1016/j.jpedsurg.2005.03.002