THORACOSCOPIC POSTERIOR TRACHEOPEXIE IN A NEWBORN WITH TRACHEOMALACIA AND ESOPHAGEAL ATRESIA

Abstract

Introduction. Esophageal atresia is often accompanied by some form of tracheomalacia. Soon after birth, tracheal collapse can result in respiratory disturbances of various degrees – from mild to severe – requiring artifcial pulmonary ventilation. In this study, we describe the use of a new treatment method of tracheomalacia with posterior tracheopexie.Material and methods. A patient with tracheomalacia that developed against the background of esophageal atresia was presented in the study. A newborn boy of 2,720 g had a prenatally established diagnosis of esophageal atresia. The infant was born with the signs of respiratory disturbances. Following tracheoscopy, severe tracheomalacia was established with complete collapse of tracheal lumen. During the next thoracoscopic procedure, the trachea was fxed to the anterior longitudinal spinal ligament with several sutures.Results. Thoracoscopic posterior tracheopexie was performed prior to esophageal anastomosis. Overall duration of surgery was 85 minutes. Spontaneous breathing was restored at day 3 after the surgery. Tracheoscopy performed at day 10 after the surgery demonstrated a complete opening of the tracheal lumen.Conclusion. Promising results of the surgery prove that the procedure is effective for the treatment of tracheomalacia. Moreover, more complex (aortopexy) recurrent surgeries can be prevented using this approach as posterior tracheopexie can be performed during the primary thoracoscopic correction of esophageal atresia.