Tracheoplasty for Expiratory Collapse of Central Airways

摘要: Background Severe central airway obstruction due to expiratory collapse occurs with malacia of intrathoracic trachea and main bronchi, often chronic obstructive pulmonary disease. Bronchoscopically observed, it is confirmed by inspiratory-expiratory computerized tomographic chest scans. Prior attempts at surgical stabilization have not given dependable results. Methods Posterior tracheobronchial splinting polypropylene mesh (Marlex) holds cartilages in more normal configuration, fixes redundant membranous walls. Fourteen consecutive patients were so treated for severe dyspnea. trials various autologous exogenous splints failed. Results All felt subjectively improved early, decreased dyspnea, cough, secretion retention, increased activities. Mean forced volume 1 second rose from 51% predicted 73% ( p = 0.009), peak flow rate 49% 70% Conclusions Complete all malacic airways Marlex restores anatomic configuration permanently prevents collapse, relief extreme retention.