[Strategy of surgical management of juvenile on-set recurrent respiratory papillomatosis with trachea or bronchia involvement.].
OBJECTIVE
To investigate the strategy of surgical management of juvenile on-set recurrent respiratory papillomatosis (JORRP) with trachea/bronchia involvement so as to decrease the complications of the surgery.


METHODS
Twenty four JORRP patients undergone surgery in Beijing Tongren Hospital were studied between January 2006 and February 2009. All of them had JORRP with trachea/bronchia involvement. Suspension laryngoscopic surgeries were performed using rigid bronchoscope and micro-debrider. High frequency jet ventilator was used to maintain the ventilation in general anesthesia. Excision of tumors, suction of the blood and ventilation were preformed alternately. A total of 149 times of surgeries were analyzed.


RESULTS
The age of the patients was from 3 to 16 years old (median 6 years old). The age at diagnosis was from eight months to 10 years old (median 1.5 years old). Twenty of them had undergone tracheostomy and the age at tracheostomy was from 1 to 4 years old (median 2 years old). Twenty two of them had been graded as two-degree dyspnea preoperatively, one graded as three-degree dyspnea and one four-degree dyspnea. All subjects underwent more than one surgery. Two cases were intubated and sent to intensive care unit because of postoperative hypercapnia. One was sent to intensive care unit postoperatively because of preoperative phypoxemia and hypercapnia. All subjects were discharged without dyspnea. No death and complications occurred.


CONCLUSIONS
Suspension laryngoscopic surgery using rigid bronchoscope and micro-debrider was a safe and effective strategy for the treatment of JORRP with trachea/bronchia involvement.
Yang
Qing-Wen
QW
Beijing Tongren Hospital, Capital Medical University Key Laboratory of Otorhinolaryngology Head and Neck Surgery, Ministry of Education. Beijing 100730, China.
Ye
Jing-Ying
JY
Wang
Jun
J
Wang
Xiao-Yi
XY
Ma
Li-Jing
LJ
D000293:Adolescent; D000768:Anesthesia, General; D001999:Bronchoscopy; D006801:Humans; D007828:Laryngoscopy; D010212:Papilloma / Q000601:surgery; D012189:Retrospective Studies; D014132:Trachea; D014139:Tracheostomy