Universität zu Köln

Fischer, Janina, Balleisen, Johannes, Holzki, Josef, Cernaianu, Grigore, Alcazar, Miguel Alejandre and Duebbers, Martin (2020). Tracheoscopic Findings and Their Impact on Respiratory Symptoms in Children with Esophageal Atresia. Eur. J. Pediatr. Surg., 30 (4). S. 371 - 378. STUTTGART: GEORG THIEME VERLAG KG. ISSN 1439-359X

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Abstract

Introduction Esophageal atresia (EA) is often accompanied by tracheobronchial malformations leading to stridor, recurrent bronchitis, and occasionally to life-threatening obstructive apnea after surgical repair. The aim of this study was to identify the presence of tracheomalacia in patients with EA and tracheoesophageal fistula (TEF) pre- and postoperatively and to find endoscopic correlates leading to clinical airway symptoms. Methods In a cohort of 362 patients with EA-TEF who underwent 595 tracheoscopies at the Children's Hospital of Cologne between January 1983 and December 2002, impaired tracheal lumen, localization of TEF, tracheal pulsations, and corresponding clinical symptoms were retrospectively analyzed. Results The incidence of tracheomalacia was higher in patients with EA and TEF (Gross B-D) compared with patients with EA alone (Gross A) and average tracheal collapse does not significantly change before and after surgical repair of the esophagus in all types. Patients with cyanosis while eating and obstructive apnea presented with an average tracheal collapse of 89%. The presence of respiratory symptoms such as cough, stridor, or bronchitis was not associated with a higher grade of tracheal collapse compared with patients without any airway symptoms (average tracheal collapse of 37% in symptomatic patients vs. 33% in nonsymptomatic patients). Conclusion Tracheomalacia tends to be present independently of surgical procedure. Tracheomalacia should be measured by tracheoscopy (in % of tracheal collapse). Patients with a tracheal collapse of >80%, a ventral pulsation, and obstructive apnea or cyanosis in combination, are at risk for life-threatening situations and further surgical treatment should be considered.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Fischer, Janina UNSPECIFIED UNSPECIFIED UNSPECIFIED Balleisen, Johannes UNSPECIFIED UNSPECIFIED UNSPECIFIED Holzki, Josef UNSPECIFIED UNSPECIFIED UNSPECIFIED Cernaianu, Grigore UNSPECIFIED UNSPECIFIED UNSPECIFIED Alcazar, Miguel Alejandre UNSPECIFIED UNSPECIFIED UNSPECIFIED Duebbers, Martin UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-325124
DOI:	10.1055/s-0039-1683871
Journal or Publication Title:	Eur. J. Pediatr. Surg.
Volume:	30
Number:	4
Page Range:	S. 371 - 378
Date:	2020
Publisher:	GEORG THIEME VERLAG KG
Place of Publication:	STUTTGART
ISSN:	1439-359X
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language TRACHEOESOPHAGEAL FISTULA; PULMONARY-FUNCTION; REPAIR; TRACHEOBRONCHOMALACIA; TRACHEOMALACIA; TERM; LARYNGOTRACHEOBRONCHOSCOPY; ADOLESCENTS; MORBIDITY; AORTOPEXY Multiple languages Pediatrics; Surgery Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/32512