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

Pediatr Surg Int. 2013 Nov;29(11):1165-9. doi: 10.1007/s00383-013-3383-8.

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.

MeSH terms

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

Substances

  • Polytetrafluoroethylene