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RESULTS OF TREATMENT OF CONGENITAL TRACHEAL STENOSIS IN SEVERE RESPIRATORY FAILURE PATIENTS REQUIRING VENTILATORS AT A CENTRAL PEDIATRIC HOSPITAL
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Abstract
Congenital trachea stenosis, who have a respiratory failure that required mechanical ventilation, is a life-threatening condition. We evaluated the outcomes for those patients who underwent surgical treatment at Heart Center-Vietnam National Children’s Hospital. From December 2016 to May 2022, a total of 31 patients who underwent surgical repair required preoperative ventilation due to congenital trachea stenosis were retrospective studies. The median age at operation was 136 days, and the median weight at operation was 5,8kg. There were 20 males and 11 females (ratio 2/1). Nine patients (29%) have positive results of bacterial or virus with endotracheal tube culture before the operation, and 16 patients (51,6%) have positive results with endotracheal tube culture postoperative. There were 23 patients (74,2%) associated with intracardiac anomalies, with 19 patients (61,3%) who have a pulmonary artery sling. The slide tracheoplasty was performed in all cases, except one case with resection and end-to-end anastomosis. The median length of trachea stenosis was 4,2cm (2 - 6 cm). The mean bypass time was 133,66 ± 55,28 minutes, the mean ventilation time was 196,41 ± 216,09 hours, and the mean days' postoperative length of stay was 25,19 ± 11,10 days. There were 5 patients (16,15%) died in hospital, and 1 late death (3,2%). The last follow-up results show excellent results, with only one patient who has unilateral vocal cord paralysis. During the same study time, an additional 62 patients required surgical treatment for congenital trachea stenosis, who have spontaneous breathing, at Heart Center- Vietnam National Children's Hospital with only one early death. Results of surgical repair for patients who have a critical respiratory failure due to congenital trachea stenosis were good at Vietnam National Children’s Hospital. Earlier detection of this rare congenital disease may improve the outcomes of treatments.
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Keywords
Congenital trachea stenosis, slide tracheoplasty, critical respiratory failure, mechanical ventilation.
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