胸腔镜下后入路气管固定术治疗气管软化症：一种微创技术。
Thoracoscopic posterior tracheopexy for tracheomalacia: A minimally invasive technique.
作者信息
Polites Stephanie F, Kotagal Meera, Wilcox Lyndy J, de Alarcon Alessandro, Benscoter Dan T, von Allmen Daniel
机构信息
Division of General and Thoracic Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
Department of Otolaryngology-Head and Neck Surgery, University Cincinnati, Cincinnati, Ohio.
出版信息
J Pediatr Surg. 2018 Nov;53(11):2357-2360. doi: 10.1016/j.jpedsurg.2018.08.004. Epub 2018 Aug 24.
BACKGROUND
Tracheomalacia is the most common congenital abnormality of the trachea. Posterior tracheopexy to alleviate posterior intrusion contributing to dynamic tracheal collapse has been reported using thoracotomy or median sternotomy. Here we describe the minimally invasive operative technique of thoracoscopic posterior tracheopexy with bronchoscopic guidance.
OPERATIVE TECHNIQUE
After preoperative computed tomography and bronchoscopy, a right thoracoscopic approach is utilized. The esophagus is mobilized and the membranous trachea is sutured to the prevertebral fascia under direct bronchoscopic visualization. Immediate improvement in tracheal collapse is noted. No major complications are reported and length of stay is short. Aortopexy may also be required to address anterior vascular compression.
CONCLUSION
Thoracoscopic posterior tracheopexy is safe and feasible. Further studies with more patients and longer follow-up are needed to assess durability.
背景
气管软化是最常见的先天性气管异常。据报道，采用开胸手术或正中胸骨切开术进行气管后固定术，以减轻导致动态气管塌陷的后壁内陷。在此，我们描述在支气管镜引导下进行胸腔镜气管后固定术的微创操作技术。
手术技术
术前进行计算机断层扫描和支气管镜检查后，采用右侧胸腔镜入路。游离食管，并在直接支气管镜观察下将膜性气管缝合至椎前筋膜。气管塌陷立即得到改善。未报告重大并发症，住院时间短。可能还需要进行主动脉固定术以解决前方血管压迫问题。
结论
胸腔镜气管后固定术安全可行。需要更多患者和更长随访时间的进一步研究来评估其持久性。
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