Department of Pediatric Surgery, University Children's Hospital, Jagiellonian University, Poland.
Adv Clin Exp Med. 2019 Jul;28(7):961-965. doi: 10.17219/acem/94391.
Tracheobronchomalacia is the most common cause of congenital airway obstruction in infants. An alternative for surgical approach (aortopexy) can be metallic airway stents. Usually, they are not considered as a first choice because of the relatively high risk of complications. Recent years have brought encouraging reports of biodegradable stents applied in children.
The aim of this study was to report our experience in the treatment of airway malacia using biodegradable stents.
Six polydioxanone (PDS), self-expanding custom-made stents (ELLA-CS) were implanted in 2 children: 3 in the patient with left main bronchus occlusion due to postpnemonectomy syndrome and 3 stents in the baby with tracheomalacia.
Airway collapse was always relieved after stent expansion. Both patients needed repeated stenting because of limited stent lifespan. All the stents were implanted without complications through a rigid bronchoscope. The baby with stented main bronchus died because of irreversible lung lesion.
This small study shows that biodegradable airway stents seem to be an attractive option in the treatment of tracheobronchomalacia in children. We consider this method to be safe, effective, repeatable, and reversible in small children with growing airways. As a time-buying procedure they can be especially useful in the treatment of tracheobronchomalacia.
气管支气管软化症是婴儿先天性气道阻塞的最常见原因。一种替代的手术方法(主动脉固定术)可以是金属气道支架。由于并发症的相对风险较高,通常不将其视为首选。近年来,可生物降解支架在儿童中的应用带来了令人鼓舞的报告。
本研究旨在报告我们使用可生物降解支架治疗气道软化症的经验。
在 2 名儿童中植入了 6 个聚二恶烷酮(PDS)、自膨式定制支架(ELLA-CS):3 个用于因肺炎后综合征导致左主支气管闭塞的患者,3 个支架用于气管软化症的婴儿。
支架扩张后气道塌陷总是得到缓解。由于支架寿命有限,两名患者都需要重复支架置入。所有支架均通过硬性支气管镜无并发症地植入。主支气管支架置入的婴儿因不可逆的肺部病变而死亡。
这项小型研究表明,可生物降解气道支架似乎是治疗儿童气管支气管软化症的一种有吸引力的选择。我们认为这种方法在气道不断生长的小儿童中是安全、有效、可重复和可逆转的。作为一种时间购买的方法,它们在治疗气管支气管软化症方面特别有用。