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The Value of Preoperative Rigid Tracheobronchoscopy for the Diagnosis of Tracheomalacia in Oesophageal Atresia Patients.

The Value of Preoperative Rigid Tracheobronchoscopy for the Diagnosis of Tracheomalacia in Oesophageal Atresia Patients.

Authors :
van Hal ARL
Aanen IP
Wijnen RMH
Pullens B
Vlot J
Source :
Journal of pediatric surgery [J Pediatr Surg] 2024 Nov; Vol. 59 (11), pp. 161620. Date of Electronic Publication: 2024 Jul 14.
Publication Year :
2024

Abstract

Background: Oesophageal atresia (OA) is often accompanied by tracheomalacia (TM). The aim of this study was to evaluate its presence in OA patients during routine rigid tracheobronchoscopy (TBS) before primary correction and compare this to postoperative TBS and clinical signs of TM.<br />Methods: This retrospective cohort study included patients born with OA between June 2013 and December 2022 who had received a TBS before OA correction and had been followed for at least twelve months. Definite TM was postoperatively diagnosed through TBS, and probable TM was defined as having symptoms of TM.<br />Results: We analysed data from 79 patients, of whom 87% with OA type C. Preoperatively, TM was observed in 33 patients (42% of all patients), seven of whom had severe TM. Definite TM was observed in 21 patients (27%), of whom 15 had severe TM. Forty-one patients (52% of all patients) had developed symptoms of TM within twelve months, including harsh barking cough (n = 15), stridor and/or wheezing (n = 20), recurrent respiratory insufficiency (n = 11), or needing airway surgery (n = 7). The sensitivity of preoperative TBS for the presence of postoperative (definite and probable combined) TM is 50.0%, 95% CI [35.2-64.8], and the specificity 67.6%, 95% CI [51.7-81.1]. Clinical characteristics did not differ between the patients with or without postoperative TM.<br />Conclusions: More than half of the studied patients with OA experienced symptoms of TM. While preoperative TBS is routinely performed prior to surgical OA correction, its predictive value for the presence of postoperative TM remains limited.<br />Level of Evidence: Level II.<br />Type of Study: Study of Diagnostics Test.<br />Competing Interests: Conflicts of interest The authors have no relevant financial or non-financial interests to disclose.<br /> (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)

Details

Language :
English
ISSN :
1531-5037
Volume :
59
Issue :
11
Database :
MEDLINE
Journal :
Journal of pediatric surgery
Publication Type :
Academic Journal
Accession number :
39089893
Full Text :
https://doi.org/10.1016/j.jpedsurg.2024.07.005