Balloon dilatation of tracheal restenosis in a patient with unilateral lung agenesis – an anesthetic challenge

Gopinathan, V P; Guruswamy, Velupandian

doi:10.1111/j.1460-9592.2011.03613.x

Cited by 1 publication

(1 citation statement)

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“…If the stenosis is severe or caused by tracheal rings, tracheal reconstruction may be a better choice but it is at high risk of surgical complications 32 . Following the successful repair of the tracheal stenosis, these children need repeated bronchoscopies for assessing the tracheal growth, tracheostomy for bronchial toileting, balloon dilation for restenosis, or stent insertion to maintain the patency to improve the long‐term outcome 32,33 . No previous studies demonstrated the long‐term follow‐up data of infants receiving tracheal surgery for unilateral pulmonary agenesis.…”

Section: Discussionmentioning

confidence: 99%

Clinical outcomes of pulmonary agenesis: A systematic review of the literature

Fukuoka

Yamamura

Nagata

et al. 2022

Pediatric Pulmonology

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Introduction Pulmonary agenesis is a complete absence of the pulmonary parenchyma, airways, and vasculature unilaterally or bilaterally. Although bilateral cases are lethal, the outcome of unilateral cases remains not well described. We performed a comprehensive literature review to assess the clinical features of pulmonary agenesis. Methods Four database sources were searched on October 10, 2021 and two cases were included from our institution. Studies related to the clinical impact of comorbidity and intervention on the survival outcome in pulmonary agenesis were included for full‐text review. Results We identified 259 patients—with right‐sided (59%), left‐sided (34%), and bilateral agenesis (7%)—among 195 articles and our two cases. Additional anomalies included cardiovascular (40%), skeletal (30%), gastrointestinal (20%), tracheal (20%: all stenoses), and genitourinary (14%) anomalies. Fifty‐seven (24%) individuals in unilateral pulmonary agenesis had isolated disease. Outcomes related to survival were not uniformly reported, but the 2‐year overall survival rate of unilateral agenesis was 62% and no subsequent death was reported until 13 years of age. The right‐sided agenesis was more frequently associated with tracheal stenosis (27% vs. 11%, p = 0.003) than the left‐sided disease. A multivariable analysis indicated that tracheal stenosis (hazard ratio [HR]: 2.2, 95% confidence interval [CI]: 1.3–4.1, p = 0.003) and gastrointestinal anomalies (HR: 2.0, 95% CI: 1.1–3.3, p = 0.010) were prognostic factors for mortality. Conclusions The poor prognostic factors were tracheal stenosis, right agenesis, and gastrointestinal anomalies. Treatment for these comorbidities is a key point for improving the survival of unilateral pulmonary agenesis.

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Section: Discussionmentioning

confidence: 99%