目的:支气管异常是儿童罕见但具有挑战性的疾病,包括各种可能损害气道通畅的结构异常。这包括完整的戒指,软骨缺失,创伤性撕脱,支气管食管瘘,和软骨袖子。这项研究的目的是描述通过滑动气管支气管成形术治疗的一系列小儿支气管异常病例的特征和结果。
方法:这是2004年2月至2020年4月期间接受手术治疗的支气管异常儿科患者的单机构回顾性病例系列。从电子病历中提取的数据包括患者人口统计数据,合并症,和手术结果。
结果:本研究共纳入29例患者,其中14个有完整的支气管环,8人没有支气管环,4人患有创伤性支气管撕脱,2有支气管食管瘘,其中一个有软骨袖子。中位随访时间为13个月(0.5-213个月)。总死亡率为17.2%(5例),他们都有完整的支气管环。具有完整支气管环的患者不仅心脏合并症(85.7%)和肺部合并症(85.7%),而且继发性气道病变(78.6%)的发生率也较高。
结论:这是迄今为止描述支气管畸形手术治疗的最大系列。完整的支气管环是最常见的异常治疗,其次是缺环和外伤。手术治疗可以成功,但完整支气管环患者的死亡率较高,可能是由于肺部和心脏合并症的发生率较高。
方法:4喉镜,2023年。
Bronchial anomalies are rare but challenging conditions to treat in children, encompassing a variety of structural abnormalities that could compromise airway patency. This includes complete rings, absent cartilage, traumatic avulsions, bronchoesophageal fistulas, and cartilaginous sleeves. The objective of this study is to describe the characteristics and outcomes of a series of pediatric cases of bronchial anomalies that were treated by slide tracheobronchoplasty.
This is a single-institution retrospective case series of pediatric patients with bronchial anomalies who underwent surgical treatment between February 2004 and April 2020. Data extracted from electronic medical records included patient demographics, comorbidities, and surgical outcomes.
There were a total of 29 patients included in the study, of which 14 had complete bronchial rings, 8 had absent bronchial rings, 4 had traumatic bronchial avulsions, 2 had bronchoesophageal fistulas, and one had a cartilaginous sleeve. Median follow-up time was 13 months (with a range of 0.5-213 months). The overall mortality rate was 17.2% (5 patients), all of whom had complete bronchial rings. Patients with complete bronchial rings also had a higher rate of not only cardiac (85.7%) and pulmonary comorbidities (85.7%) but also secondary airway lesions (78.6%).
This is the largest series to date describing surgical treatment for bronchial anomalies. Complete bronchial rings were the most common anomaly treated, followed by absent rings and trauma. Surgical treatment can be successful but mortality rates are higher in patients with complete bronchial rings, possibly due to higher rates of pulmonary and cardiac comorbidities.
4 Laryngoscope, 133:3334-3340, 2023.