Abstract：
BACKGROUND: Vascular Rings (VRs) are congenital malformations of the aortic arch that can compress the trachea and esophagus producing symptoms. Approximately, 5%-10% of patients experience persistent symptoms postrepair and 9% require reintervention. There are various approaches to repair-simple ligation and division of the ring or more complex procedures. Our objective was to describe outcomes for VR repair using a \"simple\" surgical approach.
METHODS: We identified patients who underwent VR repair from 2012 to 2022 at our institution. Clinical and surgical data, demographics, intraoperative, and postoperative outcomes were extracted from their electronic medical records. Outcomes were analyzed and regression analysis was used to identify risk factors for residual symptoms after repair.
RESULTS: Ninety three patients with VR repair were included. Prevalence of symptoms were reduced following surgery (80% preoperative versus 13% postoperative, P 0.03). Tracheomalacia also decreased from 16% to 7% postrepair. No deaths were reported in our cohort and 2% of our patients required reintervention. Multivariable regression analysis showed that preoperative tracheomalacia was associated with having persistent symptoms after VR repair (odds ratio 6.2, 95% CI 1.02-37.6).
CONCLUSIONS: Our institutional experience using a simple surgical approach showed a significant decrease in symptoms, a very low reintervention rate and no mortality. Preoperative tracheomalacia can be a risk factor for persistent symptoms postrepair. We believe a simple surgical approach for children with complete VR repair can be effective in relieving symptoms.
METHODS: We identified patients who underwent VR repair from 2012 to 2022 at our institution. Clinical and surgical data, demographics, intraoperative, and postoperative outcomes were extracted from their electronic medical records. Outcomes were analyzed and regression analysis was used to identify risk factors for residual symptoms after repair.
RESULTS: Ninety three patients with VR repair were included. Prevalence of symptoms were reduced following surgery (80% preoperative versus 13% postoperative, P 0.03). Tracheomalacia also decreased from 16% to 7% postrepair. No deaths were reported in our cohort and 2% of our patients required reintervention. Multivariable regression analysis showed that preoperative tracheomalacia was associated with having persistent symptoms after VR repair (odds ratio 6.2, 95% CI 1.02-37.6).
CONCLUSIONS: Our institutional experience using a simple surgical approach showed a significant decrease in symptoms, a very low reintervention rate and no mortality. Preoperative tracheomalacia can be a risk factor for persistent symptoms postrepair. We believe a simple surgical approach for children with complete VR repair can be effective in relieving symptoms.
摘要：
背景：血管环（VRs）是先天性主动脉弓畸形，可以压迫气管和食道产生症状。大约,5％-10％的患者在术后出现持续症状，9％的患者需要再次干预。存在各种修复方法-简单的连接和环的分裂或更复杂的程序。我们的目的是描述使用“简单”手术方法进行VR修复的结果。
方法：我们确定了2012年至2022年在我们机构接受VR修复的患者。临床和手术数据，人口统计，术中,从他们的电子病历中提取术后结局.结果分析和回归分析用于确定修复后残留症状的危险因素。
结果：纳入93例VR修复患者。手术后症状患病率降低（术前80%对术后13%，P0.03)。气管软化也从16％下降到7％。在我们的队列中没有死亡报告，2%的患者需要再次干预。多因素回归分析显示，术前气管软化与VR修复后症状持续相关（比值比6.2，95%CI1.02-37.6）。
结论：我们使用简单手术方法的机构经验表明，症状显着减少，再干预率极低，无死亡率。术前气管软化可能是术后持续症状的危险因素。我们相信，对于完全VR修复的儿童，简单的手术方法可以有效缓解症状。
方法：我们确定了2012年至2022年在我们机构接受VR修复的患者。临床和手术数据，人口统计，术中,从他们的电子病历中提取术后结局.结果分析和回归分析用于确定修复后残留症状的危险因素。
结果：纳入93例VR修复患者。手术后症状患病率降低（术前80%对术后13%，P0.03)。气管软化也从16％下降到7％。在我们的队列中没有死亡报告，2%的患者需要再次干预。多因素回归分析显示，术前气管软化与VR修复后症状持续相关（比值比6.2，95%CI1.02-37.6）。
结论：我们使用简单手术方法的机构经验表明，症状显着减少，再干预率极低，无死亡率。术前气管软化可能是术后持续症状的危险因素。我们相信，对于完全VR修复的儿童，简单的手术方法可以有效缓解症状。
