title: External stabilization for severe tracheobronchomalacia using separated ring-reinforced ePTFE grafts is effective and safe on a long-term basis.
abstract: OBJECTIVE
  Tracheobronchomalacia is a respiratory disorder that results from abnormal cartilage development. Since 2003, we have performed external stabilization for severe tracheobronchomalacia using separated ring-reinforced expanded polytetrafluoroethylene (ePTFE) grafts. The aim of this study was to analyze the short- and long-term outcomes of our procedure.
  
  
  METHODS
  We reviewed the charts of patients who underwent external tracheobronchial stabilization from January 2003 through December 2012. Separated ring-reinforced ePTFE grafts were fixed to the anterior and posterior lesions of malacia independently, with confirmation of a well-opened lumen by bronchoscopy.
  
  
  RESULTS
  Five children with severe tracheobronchomalacia underwent six operations. The median follow-up period was 43 months (range 11-109 months). There was no operative mortality associated with the procedure. One patient required removal of a section of the graft owing to the development of bronchial granulation tissue at the site of fixation. All patients showed improved respiratory function, and tracheal growth was confirmed by follow-up computed tomography.
  
  
  CONCLUSIONS
  External stabilization with separated ring-reinforced ePTFE grafts for severe tracheobronchomalacia is effective, less invasive than alternatives and preserves the growth potential of the affected airway segment.
authors: Department of Pediatric Surgery, Saitama Children's Medical Center, 2100 Magome, Iwatsuki-ku, Saitama, Saitama, 339-8551, Japan, shinya.takazawa@gmail.com.
authors: Shinya
authors: S
authors: Takazawa
authors: Hiroo
authors: H
authors: Uchida
authors: Hiroshi
authors: H
authors: Kawashima
authors: Yujiro
authors: Y
authors: Tanaka
authors: Takayuki
authors: T
authors: Masuko
authors: Kyoichi
authors: K
authors: Deie
authors: Yuzo
authors: Y
authors: Nagase
authors: Tadashi
authors: T
authors: Iwanaka
mesh_terms: D001980:Bronchi / Q000601:surgery*; D001999:Bronchoscopy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D011138:Polytetrafluoroethylene; D019736:Prostheses and Implants; D011474:Prosthesis Design; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013536:Suture Techniques; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D014132:Trachea / Q000601:surgery*; D055089:Tracheobronchomalacia / Q000175:diagnosis / Q000601:surgery*; D016896:Treatment Outcome
chemical_list: D011138:Polytetrafluoroethylene
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