Journal of pediatric surgery · 2026
Posterior tracheopexy for pediatric tracheomalacia: A global evidence synthesis and meta-analysis.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Singh Sehajnoor, Chawla Dikshit, Pessoa Tályta, Yu Leo, Pimpalwar Ashwin
Аннотация
BACKGROUND: Severe pediatric tracheomalacia (TM) causes dynamic expiratory airway collapse resulting in recurrent infections, cyanotic spells, respiratory support dependence, and significant morbidity. Posterior tracheopexy (PT) has emerged as a physiologically targeted reconstructive strategy; however, pooled outcome data are limited. Thus, we performed a systematic review and meta-analysis to evaluate the efficacy and safety of PT in children with TM.
METHODS: PubMed, Embase, Scopus, Cochrane Library, and Google Scholar were searched for studies reporting postoperative outcomes of PT in patients <18 years. Primary outcomes were respiratory symptom improvement and overall symptom resolution. Secondary outcomes included recurrent infections, supplemental oxygen requirement, reintervention, acquired/recurrent tracheoesophageal fistula (TEF), complications, blue spells/brief resolved unexplained events (BRUEs), and mortality. Random-effects generalized linear mixed models generated pooled proportions. Heterogeneity was assessed using I2 statistics. Prespecified subgroup analyses evaluated reintervention by operative approach and by the presence of esophageal atresia (EA)/TEF.
RESULTS: Fourteen observational studies (n = 318) met the inclusion criteria. Respiratory symptom improvement occurred in 91.03% (95% CI: 86.63-94.08; I2 = 0%) and overall symptom resolution in 95.7% (95% CI: 76.3-99.4; I2 = 0%). Blue spells/BRUEs declined to 0.6% (95% CI: 0.04-8.3; I2 = 0%). Recurrent infections decreased to 10.60% (95% CI: 5.08-20.78; I2 = 33.3%), and supplemental oxygen requirement to 15.0% (95% CI: 3.0-50.6; I2 = 66.6%). Reintervention occurred in 9.1% (95% CI: 4.9-16.4; I2 = 0%). Acquired/recurrent TEF occurred in 5.7% (95% CI: 1.8-16.1; I2 = 0%), and overall complications in 19.6% (95% CI: 13.0-28.5; I2 = 0%), with no perioperative mortality. Subgroup analyses demonstrated no statistically significant differences in reintervention by operative approach (p = 0.26) or EA/TEF status (p = 0.67).
CONCLUSIONS: PT is associated with high rates of symptom improvement, near-elimination of cyanotic episodes, low reintervention rates, and negligible mortality. Prospective multicenter comparative studies are required to define long-term durability and comparative effectiveness.
METHODS: PubMed, Embase, Scopus, Cochrane Library, and Google Scholar were searched for studies reporting postoperative outcomes of PT in patients <18 years. Primary outcomes were respiratory symptom improvement and overall symptom resolution. Secondary outcomes included recurrent infections, supplemental oxygen requirement, reintervention, acquired/recurrent tracheoesophageal fistula (TEF), complications, blue spells/brief resolved unexplained events (BRUEs), and mortality. Random-effects generalized linear mixed models generated pooled proportions. Heterogeneity was assessed using I2 statistics. Prespecified subgroup analyses evaluated reintervention by operative approach and by the presence of esophageal atresia (EA)/TEF.
RESULTS: Fourteen observational studies (n = 318) met the inclusion criteria. Respiratory symptom improvement occurred in 91.03% (95% CI: 86.63-94.08; I2 = 0%) and overall symptom resolution in 95.7% (95% CI: 76.3-99.4; I2 = 0%). Blue spells/BRUEs declined to 0.6% (95% CI: 0.04-8.3; I2 = 0%). Recurrent infections decreased to 10.60% (95% CI: 5.08-20.78; I2 = 33.3%), and supplemental oxygen requirement to 15.0% (95% CI: 3.0-50.6; I2 = 66.6%). Reintervention occurred in 9.1% (95% CI: 4.9-16.4; I2 = 0%). Acquired/recurrent TEF occurred in 5.7% (95% CI: 1.8-16.1; I2 = 0%), and overall complications in 19.6% (95% CI: 13.0-28.5; I2 = 0%), with no perioperative mortality. Subgroup analyses demonstrated no statistically significant differences in reintervention by operative approach (p = 0.26) or EA/TEF status (p = 0.67).
CONCLUSIONS: PT is associated with high rates of symptom improvement, near-elimination of cyanotic episodes, low reintervention rates, and negligible mortality. Prospective multicenter comparative studies are required to define long-term durability and comparative effectiveness.