Abstract：
In tracheobronchomalacia, the structural weakening of the airway results in altered ventilatory mechanics. This case report describes a patient with known tracheobronchomalacia who experienced expiratory central airway collapse and dynamic pulmonary hyperinflation during peroral endoscopic myotomy (POEM) to treat symptomatic achalasia. We discuss the physiological considerations and potential complications of a POEM procedure with superimposed tracheobronchomalacia and present perioperative strategies for the prevention and management of this potentially deleterious combination. Although tracheobronchomalacia was a known condition in our patient, it is likely an underdiagnosed condition that may first present intraoperatively.
摘要：
气管支气管软化症，气道的结构弱化导致通气力学改变。此病例报告描述了一名患有已知气管支气管软化症的患者，该患者在经口内窥镜肌切开术（POEM）治疗有症状的门失弛缓症期间经历了呼气性中央气道塌陷和动态肺过度充气。我们讨论了合并气管支气管软化的POEM手术的生理考虑因素和潜在并发症，并提出了预防和处理这种潜在有害组合的围手术期策略。虽然气管支气管软化症是我们病人的一种已知疾病，这可能是一种未诊断的疾病，可能首先在术中出现。
