BOB Ped Surg 2023 - Basma Magdy, PAPSA - Presentation
Timestops (12)
Tools Used
Topic Overview
Key Takeaways
- Tracheomalacia occurs in up to 80% of esophageal atresia patients, far higher than the previously estimated 1/3.
- Preoperative rigid bronchoscopy assessment during spontaneous breathing and negative pressure identifies moderate-to-severe tracheomalacia.
- Concurrent thoracoscopic EA repair with tracheomalacia intervention had mean operative time 118 min, median hospital stay 9 days.
- Post-repair symptoms (cough, choking, dysphagia) in 7/17 patients were mainly due to anastomotic stricture, improved with dilatation.
- Addressing tracheomalacia at time of EA repair may improve quality of life and reduce need for future airway interventions.
Keywords
Hashtags
Transcript
Here we present our work in University Pediatric Hospital thoracoscopic repair with in patients. But it was believed that up to 1/3 of the with patients could have. However recent reports suggest that it could be encountered in up to 80% of this population. In this study we aim to study the possible benefits of in patients with with concomitant moderate to severe. This study was conducted in our institute from 2019 to 2022. We included type diagnose with moderate to severe by immediate pretive. All the patients were fit for thoracoscopic intervention. Therefore any unfit patients were excluded. Assessment of the was performed by immediate pretive rigid scope. There way assessment was performed in two phases of breathing, the spontaneous breathing and while applying a valve maneuver or applying negative pressure. The vocal cords were assessed as well as the subglotic area. The position of the tral. And the was assessed by the posterior membrane ratio to the whole circumference, the cartilage shape and the collapse. Then thoracoscopic primary repair and was performed. During the study period, 24 patients met the inclusion criteria. The procedure was completed in 22 patients. The mean operative time was 118 minutes and the me time was 15 minutes. 17 patients were discharged alive with a median post operative hospital stays of nine days. Six patients developedtic leak. Due to the early demise of seven patients, 17 patients were followed up with mean follow up period of 26 months. Only seven patients developed symptoms in the form of cough and choking and difficulty in swallowing. The symptoms were analyzed bygram, and of needed. Symptoms of in five patients were due totic structure and improved after dilatation. Two patients had symptom due to the development of recurrent and was still present in one of these patients. However, the remaining patients were considered to have successful. The main limitation of this study is the small number of patients as well as the short follow up period. We believe that attention given to the by surgeons definitely improve the quality of life of these patients. pretive determination of the need of only may alleviate their chronic respiratory conditions, but may also decrease the risk of surgical intervention.