Aim of Study: Infants with repaired esophageal atresia and distal tracheoesophageal fistula (EA/TEF) are at risk for severe respiratory distress, which is related to tracheomalacia (TM), gastroesophageal reflux, or bo...Aim of Study: Infants with repaired esophageal atresia and distal tracheoesophageal fistula (EA/TEF) are at risk for severe respiratory distress, which is related to tracheomalacia (TM), gastroesophageal reflux, or both. This usually mandates an operation for TM and/or a fundoplication procedure (FP). Methods: We retrospectively performed a 26- year review of 288 patients with repaired EA/TEF. Research Ethic Board approval was obtained. Results: Postoperatively, 22 (7.6% ) infants with EA/TEF developed severe respiratory distress. Thirteen infants had an initial TM procedure and symptoms improved in 7 (54% ). The 6 (46% ) remaining patients with ongoing respiratory symptoms required an FP. Nine infants had an initial FP and the symptoms improved in 6 (67% ). The remaining 3 (33% ) patients with ongoing respiratory symptoms required a TM procedure. All patients improved with the second procedure. Several clinical parameters were assessed among the 4 patient groups (FP only, FP followed by TM procedure, TM procedure only, and TM procedure followed by FP); there were no significant differences noted. Conclusions: Whereas 54% to 67% of infants improved with a TM procedure or FP, 33% to 46% required both surgical procedures. No clinical parameters were identified that could predict which procedure should be performed first.展开更多
Aspiration of Timothy grass in the airway is a well-recognized cause of bronc hiectasis, and management often requires pulmonary resection. The authors descri be 2 cases of Timothy grass aspiration with established pu...Aspiration of Timothy grass in the airway is a well-recognized cause of bronc hiectasis, and management often requires pulmonary resection. The authors descri be 2 cases of Timothy grass aspiration with established pulmonary infection that were successfully managed by bronchoscopic removal with subsequent improvement. Every effort should be made to accomplish this goal, and pulmonary resection sh ould be considered a last resort in these cases.展开更多
文摘Aim of Study: Infants with repaired esophageal atresia and distal tracheoesophageal fistula (EA/TEF) are at risk for severe respiratory distress, which is related to tracheomalacia (TM), gastroesophageal reflux, or both. This usually mandates an operation for TM and/or a fundoplication procedure (FP). Methods: We retrospectively performed a 26- year review of 288 patients with repaired EA/TEF. Research Ethic Board approval was obtained. Results: Postoperatively, 22 (7.6% ) infants with EA/TEF developed severe respiratory distress. Thirteen infants had an initial TM procedure and symptoms improved in 7 (54% ). The 6 (46% ) remaining patients with ongoing respiratory symptoms required an FP. Nine infants had an initial FP and the symptoms improved in 6 (67% ). The remaining 3 (33% ) patients with ongoing respiratory symptoms required a TM procedure. All patients improved with the second procedure. Several clinical parameters were assessed among the 4 patient groups (FP only, FP followed by TM procedure, TM procedure only, and TM procedure followed by FP); there were no significant differences noted. Conclusions: Whereas 54% to 67% of infants improved with a TM procedure or FP, 33% to 46% required both surgical procedures. No clinical parameters were identified that could predict which procedure should be performed first.
文摘Aspiration of Timothy grass in the airway is a well-recognized cause of bronc hiectasis, and management often requires pulmonary resection. The authors descri be 2 cases of Timothy grass aspiration with established pulmonary infection that were successfully managed by bronchoscopic removal with subsequent improvement. Every effort should be made to accomplish this goal, and pulmonary resection sh ould be considered a last resort in these cases.
