Thoracoscopic tracheoaortopexia for the treatment of life-threatening events in tracheomalacia.
BACKGROUND
Life-threatening events resulting from tracheomalacia are a well-known complication of infants with esophageal atresia. Aortopexy is accepted as the most effective method for managing severe life-threatening and localized tracheomalacia with a success rate of 85% to 90%. Since the advent of minimally invasive surgery (MIS), the procedure also can be performed using thoracoscopic MIS.


METHODS
Between January 2002 and November 2005, six children with esophageal atresia were treated using MIS for life-threatening events attributable to tracheomalacia.


RESULTS
The patients tolerated the thoracoscopic procedure well, and all tracheoaortopexies could be performed thoracoscopically. There were two recurrences, which could be treated using thoracoscopy. After a follow-up period of 27 months (range, 10-45 months), all the patients are doing well and have had no more life-threatening events.


CONCLUSIONS
Although this is the largest thoracoscopic series to date, the series is too small for any conclusions yet to be drawn. Thoracoscopic tracheoaortopexia is feasible and offers the advantages of MIS.
van der Zee
D C
DC
Department of Pediatric Surgery, Wilhelmina Children's Hospital, KE 04.140.5, P.O. Box 85090, 3508, AB, Utrecht, The Netherlands. d.c.vanderzee@umcutrecht.nl
Bax
N M A
NM
D001013:Aorta, Thoracic / Q000601:surgery*; D004933:Esophageal Atresia / Q000150:complications; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012008:Recurrence; D013906:Thoracoscopy / Q000379:methods*; D014133:Tracheal Diseases / Q000209:etiology / Q000601:surgery*; D016896:Treatment Outcome