Tracheobronchoplasty yields long-term anatomy, function, and quality of life improvement for patients with severe excessive central airway collapse,The Journal of Thoracic and Cardiovascular Surgery

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Tracheobronchoplasty yields long-term anatomy, function, and quality of life improvement for patients with severe excessive central airway collapse
The Journal of Thoracic and Cardiovascular Surgery ( IF 4.9 ) Pub Date : 2022-06-08 , DOI: 10.1016/j.jtcvs.2022.05.037
Daniel H Buitrago ₁ , Adnan Majid ₁ , Jennifer L Wilson ₁ , Daniel Ospina-Delgado ₁ , Fayez Kheir ₁ , Abraham F Bezuidenhout ₂ , Mihir S Parikh ₁ , Alex C Chee ₁ , Diana Litmanovich ₂ , Sidhu P Gangadharan ₁

Affiliation

Objectives

This study examines the long-term anatomic and clinical effects of tracheobronchoplasty in severe excessive central airway collapse.

Methods

Included patients underwent tracheobronchoplasty for excessive central airway collapse (2002-2016). The cross-sectional area of main airways on dynamic airway computed tomography was measured before and after tracheobronchoplasty. Expiratory collapse was calculated as the difference between inspiratory and expiratory cross-sectional area divided by inspiratory cross-sectional area ×100. The primary outcome was improvement in the percentage of expiratory collapse in years 1, 2, and 5 post-tracheobronchoplasty. Secondary outcomes included mean response profile for the 6-minute walk test, Cough-Specific Quality of Life Questionnaire, Karnofsky Performance Status score, and St George Respiratory Questionnaire. Repeated-measures analysis of variance was used for statistical analyses.

Results

The cohort included 61 patients with complete radiological follow-up at years 1, 2, and 5 post-tracheobronchoplasty. A significant linear decrease in the percentage of expiratory collapsibility of the central airways after tracheobronchoplasty was present. Anatomic repair durability was preserved 5 years after tracheobronchoplasty, with decrease in percentage of expiratory airway collapse up to 40% and 30% at years 1 and 2, respectively. The St George Respiratory Questionnaire (74.7 vs 41.8%, P < .001) and Cough-Specific Quality of Life Questionnaire (78 vs 47, P < .001) demonstrated significant improvement at year 5 compared with baseline. Similar results were observed in the 6-minute walk test (1079 vs 1268 ft, P < .001) and Karnofsky score (57 vs 82, P < .001).

Conclusions

Tracheobronchoplasty has durable effects on airway anatomy, functional status, and quality of life in carefully selected patients with severe excessive central airway collapse.

中文翻译：

气管支气管成形术可以为严重过度中央气道塌陷的患者带来长期的解剖结构、功能和生活质量改善

目标

本研究检查了气管支气管成形术在严重过度中央气道塌陷中的长期解剖和临床效果。

方法

纳入的患者因中央气道过度塌陷而接受气管支气管成形术 (2002-2016)。在气管支气管成形术前后测量动态气道计算机断层扫描的主气道横截面积。呼气塌陷计算为吸气和呼气横截面积之差除以吸气横截面积×100。主要结果是气管支气管成形术后第 1、2 和 5 年呼气虚脱百分比的改善。次要结果包括 6 分钟步行测试的平均反应情况、咳嗽特定生活质量问卷、Karnofsky 表现状态评分和St George 呼吸问卷。重复测量方差分析用于统计分析。

结果

该队列包括 61 名在气管支气管成形术后第 1、2 和 5 年接受完整放射学随访的患者。存在气管支气管成形术后中央气道呼气塌陷百分比的显着线性下降。气管支气管成形术后 5 年保留了解剖修复的耐久性，第 1 年和第 2 年呼气气道塌陷百分比分别降低了 40% 和 30%。St George 呼吸问卷（74.7 对 41.8%，P < .001）和咳嗽特定生活质量问卷（78 对 47，P < .001）显示第 5 年与基线相比有显着改善。在 6 分钟步行测试（1079 对 1268 英尺，P < .001）和 Karnofsky 评分（57 对 82，P <.001）。