Zhang Xing,Peng Wei.Surgical advances for airway malacia in chidren[J].Journal of Clinical Pediatric Surgery,,22():896-900.[doi:10.3760/cma.j.cn101785-202302011-019]
Surgical advances for airway malacia in chidren
- Keywords:
- Child; Airway Malacia; Surgical Procedures; Operative
- Abstract:
- Airway malacia is a common airway disease in children during flexible bronchoscopy.The major clinical manifestations include typical barking cough,wheezing,apnea and even acute life-threatening events.Severe cases tend to require surgical interventions,including intraluminal stenting,external splinting,aortopexy and tracheopexy.However,there is still no clinical consensus for guiding therapy.This review summarized the current status and recent surgical advances for airway malacia in chidren
References:
[1] Ferraro VA,Baraldi E,Stabinger D,et al.Pediatric flexible bronchoscopy:a single-center report[J].Pediatr Pulmonol,2021,56(8):2634-2641.DOI:10.1002/ppul.25458.
[2] Atag E,Unal F,Yazan H,et al.Pediatric flexible bronchoscopy in the intensive care unit:a multicenter study[J].Pediatr Pulmonol,2021,56(9):2925-2931.DOI:10.1002/ppul.25566.
[3] Wallis C,Alexopoulou E,Antón-Pacheco JL,et al.ERS statement on tracheomalacia and bronchomalacia in children[J].Eur Respir J,2019,54(3):1900382.DOI:10.1183/13993003.00382-2019.
[4] Kamran A,Jennings RW.Tracheomalacia and tracheobronchomalacia in pediatrics:an overview of evaluation,medical management,and surgical treatment[J].Front Pediatr,2019,7:512.DOI:10.3389/fped.2019.00512.
[5] Montgomery WW.T-tube tracheal stent[J].Arch Otolaryngol,1965,82:320-321.DOI:10.1001/archotol.1965.00760010322023.
[6] Dumon JF.A dedicated tracheobronchial stent[J].Chest,1990,97(2):328-332.DOI:10.1378/chest.97.2.328.
[7] Serio P,Nenna R,Fainardi V,et al.Residual tracheobronchial malacia after surgery for vascular compression in children:treatment with stenting[J].Eur J Cardiothorac Surg,2017,51(2):211-217.DOI:10.1093/ejcts/ezw299.
[8] 孟晨,刘帅帅,王少超.气道支架置入术在现代儿科介入呼吸病学的应用[J].中国实用儿科杂志,2019,34(6):485-490.DOI:10.19538/j.ek2019060609. Meng C,Liu SS,Wang SC.Application of airway stenting for interventional respiratory diseases in modern pediatrics[J].Chin J Pract Pediatr,2019,34(6):485-490.DOI:10.19538/j.ek2019060609.
[9] Filler RM,Forte V,Fraga JC,et al.The use of expandable metallic airway stents for tracheobronchial obstruction in children[J].J Pediatr Surg,1995,30(7):1050-1056.DOI:10.1016/0022-3468(95)90340-2.
[10] 杨阳,焦安夏,李晓峰,等.气管支架治疗儿童先天性心脏病合并气管梗阻的临床效果[J].中华胸心血管外科杂志,2019,35(5):260-265.DOI:10.3760/cma.j.issn.1001-4497.2019.05.002. Yang Y,Jiao AX,Li XF,et al.Clinical study of tracheal stenting for congenital heart disease with airway obstruction in children[J].Chin J Thorac Cardiovasc Surg,2019,35(5):260-265.DOI:10.3760/cma.j.issn.1001-4497.2019.05.002.
[11] 郁迪,莫绪明,彭卫,等.儿童气管狭窄的外科治疗[J].中华胸心血管外科杂志,2021,37(11):649-653.DOI:10.3760/cma.j.cn112434-20200914-00419. Yu D,Mo XM,Peng W,et al.Surgical treatment of tracheal stenosis in children[J].Chin J Thorac Cardiovasc Surg,2021,37(11):649-653.DOI:10.3760/cma.j.cn112434-20200914-00419.
[12] Mittal N,El-Said HG,Ratnayaka K,et al.Bronchial stenting in infants with severe bronchomalacia:technique and outcomes[J].Int J Pediatr Otorhinolaryngol,2021,145:110703.DOI:10.1016/j.ijporl.2021.110703.
[13] Serio P,Nenna R,Di Maurizio M,et al.Outcome of long-term complications after permanent metallic left bronchial stenting in children[J].Eur J Cardiothorac Surg,2018,53(3):610-617.DOI:10.1093/ejcts/ezx374.
[14] Wang M,Zhu B,Xu X.Follow-up investigation of 41 children after metallic airway stent implantation:an 8-year experience[J].Front Pediatr,2020,8:579209.DOI:10.3389/fped.2020.579209.
[15] Vondrys D,Elliott MJ,McLaren CA,et al.First experience with biodegradable airway stents in children[J].Ann Thorac Surg,2011,92(5):1870-1874.DOI:10.1016/j.athoracsur.2011.07.042.
[16] Harris CA,Brodlie M,O’Brien C,et al.Successful biodegradable stent insertion in an infant with severe bronchomalacia and cystic fibrosis[J].J Cyst Fibros,2021,20(2):e13-e15.DOI:10.1016/j.jcf.2020.10.004.
[17] Nacoti M,Consonni F,Bonanomi E,et al.Severe perinatal bronchomalacia in a newborn with patent ductus arteriosus[J].Am J Respir Crit Care Med,2020,201(2):e3-e4.DOI:10.1164/rccm.201902-0410IM.
[18] Antón-Pacheco JL,Luna C,García E,et al.Initial experience with a new biodegradable airway stent in children:Is this the stent we were waiting for?[J].Pediatr Pulmonol,2016,51(6):607-612.DOI:10.1002/ppul.23340.
[19] Stramiello JA,Mohammadzadeh A,Ryan J,et al.The role of bioresorbable intraluminal airway stents in pediatric tracheobronchial obstruction:a systematic review[J].Int J Pediatr Otorhinolaryngol,2020,139:110405.DOI:10.1016/j.ijporl.2020.110405.
[20] Sztanó B,Kiss G,Márai K,et al.Biodegradable airway stents in infants-potential life-threatening pitfalls[J].Int J Pediatr Otorhinolaryngol,2016,91:86-89.DOI:10.1016/j.ijporl.2016.10.013.
[21] Isik O,Akyuz M,Ozcifci G,et al.Role of aortopexy in the treatment of aberrant innominate artery in children[J].Pediatr Surg Int,2022,39(1):47.DOI:10.1007/s00383-022-05280-2.
[22] Sumida W,Tainaka T,Shirota C,et al.An imaging study on tracheomalacia in infants with esophageal atresia:the degree of tracheal compression by the brachiocephalic artery is a good indicator for therapeutic intervention[J].Pediatr Surg Int,2021,37(12):1719-1724.DOI:10.1007/s00383-021-04985-0.
[23] Williams SP,Losty PD,Dhannapuneni R,et al.Aortopexy for the management of paediatric tracheomalacia-the Alder Hey experience[J].J Laryngol Otol,2020,134(2):174-177.DOI:10.1017/s0022215120000031.
[24] Calkoen EE,Gabra HOS,Roebuck DJ,et al.Aortopexy as treatment for tracheo-bronchomalacia in children:an 18-year single-center experience[J].Pediatr Crit Care Med,2011,12(5):545-551.DOI:10.1097/PCC.0b013e3182070f6f.
[25] Hammond-Jack K,Ramakrishnan KV,Nath DS.Aortopexy for life-threatening airway obstruction following division of double aortic arch[J].World J Pediatr Congenit Heart Surg,2020,11(4):NP66-NP68.DOI:10.1177/2150135117709023.
[26] Rijnberg FM,Butler CR,Bieli C,et al.Aortopexy for the treatment of tracheobronchomalacia in 100 children:a 10-year single-centre experience[J].Eur J Cardiothorac Surg,2018,54(3):585-592.DOI:10.1093/ejcts/ezy076.
[27] Haveliwala Z,Yardley I.Aortopexy for tracheomalacia via a suprasternal incision[J].J Pediatr Surg,2019,54(2):247-250.DOI:10.1016/j.jpedsurg.2018.10.073.
[28] Torre M,Carlucci M,Speggiorin S,et al.Aortopexy for the treatment of tracheomalacia in children:review of the literature[J].Ital J Pediatr,2012,38(1):62.DOI:10.1186/1824-7288-38-62.
[29] Wong ZH,Hewitt R,Cross K,et al.Thoracoscopic aortopexy for symptomatic tracheobronchomalacia[J].J Pediatr Surg,2020,55(2):229-233.DOI:10.1016/j.jpedsurg.2019.10.034.
[30] Shieh HF,Smithers CJ,Hamilton TE,et al.Descending aortopexy and posterior tracheopexy for severe tracheomalacia and left mainstem bronchomalacia[J].Semin Thorac Cardiovasc Surg,2019,31(3):479-485.DOI:10.1053/j.semtcvs.2018.02.031.
[31] Lawlor C,Smithers CJ,Hamilton T,et al.Innovative management of severe tracheobronchomalacia using anterior and posterior tracheobronchopexy[J].Laryngoscope,2020,130(2):E65-E74.DOI:10.1002/lary.27938.
[32] 周崇高,李波,邹婵娟,等.胸腔镜下一期手术治疗食管闭锁合并气管软化的短期疗效[J].临床小儿外科杂志,2022,21(11):1062-1066.DOI:10.3760/cma.j.cn101785-202204049-012. Zhou CG,Li B,Zou CJ,et al.Short-term outcomes of one-stage thoracoscopy for esophageal atresia plus tracheomalacia[J].J Clin Ped Sur,2022,21(11):1062-1066.DOI:10.3760/cma.j.cn101785-202204049-012.
[33] Yasui A,Hinoki A,Amano H,et al.Thoracoscopic posterior tracheopexy during primary esophageal atresia repair ameliorate tracheomalacia in neonates:a single-center retrospective comparative cohort study[J].BMC Surg,2022,22(1):285.DOI:10.1186/s12893-022-01738-1.
[34] van Tuyll van Serooskerken ES,Tytgat SHAJ,Verweij JW,et al.Primary posterior tracheopexy in esophageal atresia decreases respiratory tract infections[J].Front Pediatr,2021,9:720618.DOI:10.3389/fped.2021.720618.
[35] Wen WY,Du XW,Zhu LM,et al.Surgical management of long-segment congenital tracheal stenosis with tracheobronchial malacia[J].Eur J Cardiothorac Surg,2022,61(5):1001-1010.DOI:10.1093/ejcts/ezab551.
[36] Enzer KG,Wine TM,Gien J,et al.Posterior tracheopexy for preterm infants with severe bronchopulmonary dysplasia and severe tracheobronchomalacia:a case series[J].Pediatr Pulmonol,2022,57(9):2279-2281.DOI:10.1002/ppul.26029.
[37] Vasko JS,Ahn C.Surgical management of secondary tracheomalacia[J].Ann Thorac Surg,1968,6(3):269-272.DOI:10.1016/S0003-4975(10)66023-7.
[38] Filler RM,Buck JR,Bahoric A,et al.Treatment of segmental tracheomalacia and bronchomalacia by implantation of an airway splint[J].J Pediatr Surg,1982,17(5):597-603.DOI:10.1016/s0022-3468(82)80118-8.
[39] Ando M,Nagase Y,Hasegawa H,et al.External stenting:a reliable technique to relieve airway obstruction in small children[J].J Thorac Cardiovasc Surg,2017,153(5):1167-1177.DOI:10.1016/j.jtcvs.2016.12.041.
[40] Zopf DA,Hollister SJ,Nelson ME,et al.Bioresorbable airway splint created with a three-dimensional printer[J].N Engl J Med,2013,368(21):2043-2045.DOI:10.1056/NEJMc1206319.
[41] Sood V,Green GE,Les A,et al.Advanced therapies for severe tracheobronchomalacia:a review of the use of 3D-printed,patient-specific,externally implanted,bioresorbable airway splints[J].Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu,2021,24:37-43.DOI:10.1053/j.pcsu.2021.02.001.
[42] Les AS,Ohye RG,Filbrun AG,et al.3D-printed,externally-implanted,bioresorbable airway splints for severe tracheobronchomalacia[J].Laryngoscope,2019,129(8):1763-1771.DOI:10.1002/lary.27863.
[43] Hsueh WD,Smith LP.External airway splint to treat tracheomalacia following laryngotracheal reconstruction[J].Int J Pediatr Otorhinolaryngol,2017,94:68-69.DOI:10.1016/j.ijporl.2017.01.006.
[44] Gorostidi F,Reinhard A,Monnier P,et al.External bioresorbable airway rigidification to treat refractory localized tracheomalacia[J].Laryngoscope,2016,126(11):2605-2610.DOI:10.1002/lary.25918.
[45] 张恒,张本青,段雷雷,等.应用可吸收聚左旋乳酸微骨板外固定术治疗先天性心脏病合并支气管软化-单中心经验总结[J].中国循环杂志,2020,35(1):78-81.DOI:10.3969/j.issn.1000-3614.2020.01.013. Zhang H,Zhang BQ,Duan LL,et al.External fixation with absorbable poly-L-lactic acid microplate for treating bronchomalacia plus congenital heart disease[J].Chin Circul J,2020,35(1):78-81.DOI:10.3969/j.issn.1000-3614.2020.01.013.
[46] Abia-Trujillo D,Majid A,Johnson MM,et al.Central airway collapse,an underappreciated cause of respiratory morbidity[J].Mayo Clin Proc,2020,95(12):2747-2754.DOI:10.1016/j.mayocp.2020.03.004.
[47] 刘帅帅,马静,王少超,等.先天性气管软骨环缺失4例[J].中华实用儿科临床杂志,2021,36(7):546-548.DOI:10.3760/cma.j.cn101070-20190823-00787. Liu SS,Ma J,Wang SC,et al.Congenital absence of tracheal cartilage ring:a report of 4 cases[J].Chin J Appl Clin Pediatr,2021,36(7):546-548.DOI:10.3760/cma.j.cn101070-20190823-00787.
[48] Arcieri L,Pak V,Poli V,et al.Tracheal surgery in children:outcome of a 12-year survey[J].Interact Cardiovasc Thorac Surg,2018,26(4):660-666.DOI:10.1093/icvts/ivx390.
[49] Smith MM,Kou YF,Schweiger C,et al.Congenital absence of tracheal or bronchial rings[J].Otolaryngol Head Neck Surg,2021,164(2):422-426.DOI:10.1177/0194599820950725.
[50] Greene CL,Mainwaring RD,Sidell D,et al.Lecompte procedure for relief of severe airway compression in children with congenital heart disease[J].World J Pediatr Congenit Heart Surg,2019,10(5):558-564.DOI:10.1177/2150135119860466.
[51] Kamran A,Friedman KG,Jennings RW,et al.Aortic uncrossing and tracheobronchopexy corrects tracheal compression and tracheobronchomalacia associated with circumflex aortic arch[J].J Thorac Cardiovasc Surg,2020,160(3):796-804.DOI:10.1016/j.jtcvs.2020.03.158.
[52] Chiu P,Jennings RW,Friedman KG,et al.Bronchomalacia in right aortic arch treated with descending aortic translocation and airway splint[J].Ann Thorac Surg,2022,113(3):e187-e189.DOI:10.1016/j.athoracsur.2021.04.105.
[53] 黄景思,许伟滨,饶姣,等.降主动脉移植术在主动脉畸形导致气管或支气管狭窄中的应用[J].中华胸心血管外科杂志,2021,37(7):410-413.DOI:10.3760/cma.j.cn112434-20200119-00019. Huang JS,Xu WB,Rao J,et al.Application of descending aortic translocation for tracheal or bronchial stenosis due to aortic deformity[J].Chin J Thorac Cardiovasc Surg,2021,37(7):410-413.DOI:10.3760/cma.j.cn112434-20200119-00019.
[54] Rajan S,Kalpana S,Coelho R.Aortopexy-an effective strategy for relief of left main bronchus compression[J].Cardiol Young,2020,30(8):1191-1193.DOI:10.1017/S1047951120001699.
[55] Baird CW,Prabhu S,Buchmiller TL,et al.Direct tracheobronchopexy and posterior descending aortopexy for severe left mainstem bronchomalacia associated with congenital pulmonary airway malformation and left circumflex aortic arch[J].Ann Thorac Surg,2016,102(1):e1-e4.DOI:10.1016/j.athoracsur.2015.11.065.
Memo
收稿日期:2023-2-12。
基金项目:南京市卫生科技发展项目(YKK20118)
通讯作者:彭卫,Email:pwking@sina.com