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J Pediatr Surg. 2018 Nov;53(11):2357-2360. doi: 10.1016/j.jpedsurg.2018.08.004. Epub 2018 Aug 24.

Thoracoscopic posterior tracheopexy for tracheomalacia: A minimally invasive technique.

Author information

1
Division of General and Thoracic Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
2
Department of Otolaryngology-Head and Neck Surgery, University Cincinnati, Cincinnati, Ohio.
3
Division of Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
4
Division of General and Thoracic Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, OH. Electronic address: Daniel.vonAllmen@cchmc.org.

Abstract

BACKGROUND:

Tracheomalacia is the most common congenital abnormality of the trachea. Posterior tracheopexy to alleviate posterior intrusion contributing to dynamic tracheal collapse has been reported using thoracotomy or median sternotomy. Here we describe the minimally invasive operative technique of thoracoscopic posterior tracheopexy with bronchoscopic guidance.

OPERATIVE TECHNIQUE:

After preoperative computed tomography and bronchoscopy, a right thoracoscopic approach is utilized. The esophagus is mobilized and the membranous trachea is sutured to the prevertebral fascia under direct bronchoscopic visualization. Immediate improvement in tracheal collapse is noted. No major complications are reported and length of stay is short. Aortopexy may also be required to address anterior vascular compression.

CONCLUSION:

Thoracoscopic posterior tracheopexy is safe and feasible. Further studies with more patients and longer follow-up are needed to assess durability.

KEYWORDS:

Posterior tracheopexy; Thoracoscopy; Tracheomalacia

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