Department of Pediatric Surgery, Kobe Children's Hospital, 1-6-7 Minatojimaminamimachi, Chuo-ku, Kobe, 650-0047, Japan.
Pediatr Surg Int. 2022 Dec;38(12):1903-1908. doi: 10.1007/s00383-022-05206-y. Epub 2022 Sep 9.
Although surgical outcomes have improved in patients with congenital tracheal stenosis (CTS), the management of such patients with complex cardiovascular anomalies (CVAs) remains a challenge. This study aimed to clarify the clinical features of this combination.
Medical records of 14 patients with complex CVAs who had undergone slide tracheoplasty for CTS between May 2016 and February 2022 were retrospectively reviewed. Complex CVAs were defined as CVAs without left pulmonary artery sling and simple cardiac shunts. Data collected included age and body weight at tracheal reconstruction, preoperative respiratory support, surgery details, and mortality.
The median age and body weight at tracheal reconstruction were 3.5 (range, 1-17) months and 4.7 (range, 2.3-8.2) kg, respectively. Simultaneous repair of CTS and CVAs was performed in eight patients and staged repair in six patients. Patients who underwent simultaneous repair required preoperative respiratory support more frequently than those who underwent staged repair (8/8 [100%] vs 2/6 [33.3%]; P = 0.015). No mortality occurred.
Patients with complex CVAs often require tracheal reconstruction in early infancy. Surgical management strategy for this combination was generally decided on the basis of the severity of respiratory symptoms due to CTS.
尽管先天性气管狭窄（CTS）患者的手术结果已经得到改善，但对于伴有复杂心血管异常（CVA）的此类患者的治疗仍然是一个挑战。本研究旨在阐明这种组合的临床特征。
回顾性分析了 2016 年 5 月至 2022 年 2 月期间 14 例接受滑动气管成形术治疗 CTS 的复杂 CVA 患者的病历。复杂 CVA 定义为不伴有左肺动脉吊带和单纯心脏分流的 CVA。收集的数据包括气管重建时的年龄和体重、术前呼吸支持、手术细节和死亡率。
气管重建时的中位年龄和体重分别为 3.5（范围 1-17）个月和 4.7（范围 2.3-8.2）kg。8 例患者同时进行 CTS 和 CVA 修复，6 例患者分期修复。与分期修复的患者相比，同时修复的患者更频繁地需要术前呼吸支持（8/8 [100%] vs 2/6 [33.3%]；P=0.015）。无死亡病例。
患有复杂 CVA 的患者通常需要在婴儿早期进行气管重建。这种组合的手术管理策略通常基于 CTS 引起的呼吸症状的严重程度来决定。
