Abstract：
OBJECTIVE: We evaluate long-term symptomatic improvement in vascular ring patients who underwent thoracoscopic division at a single quaternary pediatric surgery center.
METHODS: All pediatric patients who underwent vascular ring division without Kommerell\'s diverticulum resection between 01/2007-12/2022 were included. Surgeries were performed by pediatric general and thoracic surgeons. Patient demographic and clinical characteristics were obtained from retrospective chart review. Data on long-term symptomatic improvement were collected with structured telephone interviews.
RESULTS: 60% of patients were male. Median age at operation was 24 months (IQR: 11, 60 months) with a median weight of 11.3 kg (IQR: 8.7, 19.8 kg). All patients were symptomatic preoperatively with dysphagia being the most frequent complaint (42%), followed by chronic cough (21%). Of 41 patients eligible for the long-term follow-up survey, 8 patients with a primary diagnosis of a double arch with an atretic segment in the non-dominant arch and 9 with a right dominant arch with left ligamentum arteriosum and aberrant left subclavian artery (LSCA) were contacted and consented for participation. Median interval from surgery to survey completion was 95 months (IQR 28, 135 months). Most patients had no, or only minor, symptoms related to breathing and swallowing at the time of long-term follow-up. 88% of patients experienced postoperative symptom improvement, and only one patient reported worsening of symptoms over time.
CONCLUSIONS: Division of an atretic arch and/or ligamentum for patients with an aberrant LSCA without Kommerell\'s resection may be adequate to ensure long-term improvement of breathing and swallowing problems attributable to vascular rings.
METHODS: Level IV.
METHODS: All pediatric patients who underwent vascular ring division without Kommerell\'s diverticulum resection between 01/2007-12/2022 were included. Surgeries were performed by pediatric general and thoracic surgeons. Patient demographic and clinical characteristics were obtained from retrospective chart review. Data on long-term symptomatic improvement were collected with structured telephone interviews.
RESULTS: 60% of patients were male. Median age at operation was 24 months (IQR: 11, 60 months) with a median weight of 11.3 kg (IQR: 8.7, 19.8 kg). All patients were symptomatic preoperatively with dysphagia being the most frequent complaint (42%), followed by chronic cough (21%). Of 41 patients eligible for the long-term follow-up survey, 8 patients with a primary diagnosis of a double arch with an atretic segment in the non-dominant arch and 9 with a right dominant arch with left ligamentum arteriosum and aberrant left subclavian artery (LSCA) were contacted and consented for participation. Median interval from surgery to survey completion was 95 months (IQR 28, 135 months). Most patients had no, or only minor, symptoms related to breathing and swallowing at the time of long-term follow-up. 88% of patients experienced postoperative symptom improvement, and only one patient reported worsening of symptoms over time.
CONCLUSIONS: Division of an atretic arch and/or ligamentum for patients with an aberrant LSCA without Kommerell\'s resection may be adequate to ensure long-term improvement of breathing and swallowing problems attributable to vascular rings.
METHODS: Level IV.
摘要：
目的：我们评估了在单个四级儿科手术中心接受胸腔镜分割的血管环患者的长期症状改善。
方法：所有在2007-2022年1月12日期间接受血管环分割而未切除Kommerel憩室的儿科患者被纳入研究。手术由儿科普通和胸外科医师进行。患者的人口统计学和临床特征来自回顾性图表回顾。通过结构化电话访谈收集长期症状改善的数据。
结果：60%的患者为男性。手术年龄中位数为24个月（IQR：11，60个月），中位体重为11.3kg（IQR：8.7，19.8kg）。所有患者术前都有症状，吞咽困难是最常见的主诉（42%）。其次是慢性咳嗽（21%）。在符合长期随访调查条件的41名患者中，接触了8例初步诊断为双弓的患者，其中非优势弓具有闭锁段，而9例具有右优势弓的患者具有左动脉韧带和异常的左锁骨下动脉（LSCA），并同意参加。从手术到调查完成的中位间隔为95个月（IQR28，135个月）。大多数病人没有，或者只是轻微的，长期随访时与呼吸和吞咽有关的症状。88%的患者经历了术后症状改善,只有一名患者报告随着时间的推移症状恶化。
结论：对于未切除Kommerel的异常LSCA患者，隐窝弓和/或韧带的分裂可能足以确保长期改善归因于血管环的呼吸和吞咽问题。
方法：四级。
方法：所有在2007-2022年1月12日期间接受血管环分割而未切除Kommerel憩室的儿科患者被纳入研究。手术由儿科普通和胸外科医师进行。患者的人口统计学和临床特征来自回顾性图表回顾。通过结构化电话访谈收集长期症状改善的数据。
结果：60%的患者为男性。手术年龄中位数为24个月（IQR：11，60个月），中位体重为11.3kg（IQR：8.7，19.8kg）。所有患者术前都有症状，吞咽困难是最常见的主诉（42%）。其次是慢性咳嗽（21%）。在符合长期随访调查条件的41名患者中，接触了8例初步诊断为双弓的患者，其中非优势弓具有闭锁段，而9例具有右优势弓的患者具有左动脉韧带和异常的左锁骨下动脉（LSCA），并同意参加。从手术到调查完成的中位间隔为95个月（IQR28，135个月）。大多数病人没有，或者只是轻微的，长期随访时与呼吸和吞咽有关的症状。88%的患者经历了术后症状改善,只有一名患者报告随着时间的推移症状恶化。
结论：对于未切除Kommerel的异常LSCA患者，隐窝弓和/或韧带的分裂可能足以确保长期改善归因于血管环的呼吸和吞咽问题。
方法：四级。
