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. 2022 Aug 3;35(3):ivac117.
doi: 10.1093/icvts/ivac117.

Limited airway resection and reconstruction for paediatric tracheobronchial inflammatory myofibroblastic tumour

Junguo Dong  1 , Diego Gonzalez-Rivas  2 , Pengcheng Lv  1 , Zhexin Wang  3 , Jiaxi He  1 , Feng Yao  3 , Shuben Li  1
Affiliations

Limited airway resection and reconstruction for paediatric tracheobronchial inflammatory myofibroblastic tumour

Junguo Dong et al. Interact Cardiovasc Thorac Surg. .

Abstract

Objectives: The paediatric tracheobronchial inflammatory myofibroblastic tumour (IMT) is a rare disease. Whether limited surgical resection is a feasible surgical approach for these patients remains controversial. The objectives of this study were to report the long-term prognosis after limited surgical resections on paediatric tracheobronchial IMT and provide a surgical management strategy for this rare disease.

Methods: Paediatric tracheobronchial IMT patients who underwent limited surgical resection from 2012 to 2020 were enrolled in this study. The clinical characteristics, course of treatment and long-term outcomes of all participants were collated. We presented the accumulated data and analysed the feasibility of limited surgical resection on the paediatric tracheobronchial IMT.

Results: A total of 9 children with tracheobronchial IMTs were enrolled in our study. Cough and shortness of breath were the most common symptoms. All 9 participants underwent surgical treatment, including 2 tracheal reconstructions, 4 carinal reconstructions and 3 bronchial sleeve resections. Among the participants, 6/9 (66%) were positive for the anaplastic lymphoma receptor tyrosine kinase gene in terms of immunohistochemistry. None of the participants died of short-term complications. The follow-up period was 5.4 (range, 1.1-9.3) years, during which all participants remained well.

Conclusions: Limited surgical resection is preferred for paediatrics with tracheobronchial IMTs. Meanwhile, patients with complete resection have an excellent long-term prognosis.

Keywords: Paediatric; The long-term prognosis; Tracheobronchial inflammatory myofibroblastic tumour.

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Figures

Figure 1:
Figure 1:
Different tumour locations and their corresponding limited surgical resection methods. (A) Tracheal reconstruction. (B) Bronchial sleeve resection. (C) Sleeve lobectomy. (D) Carinal reconstruction.
Figure 2:
Figure 2:
Surgery pictures. (A) Visual laryngoscope for paediatric. (B) Tracheal intubation cannula for paediatric. (C) Surgical approaches. (D) Sleeve lobectomy. (E) Lesion specimen. (F) Pathological picture. LLL: left lower lobe; LMB: left main bronchi; PA: pulmonary artery.
Figure 3:
Figure 3:
Computed tomographic image of case number 3 in this study. (A) Preoperative computed tomographic image (coronal view). (B) Preoperative computed tomographic image (axial view). (C) Postoperative computed tomographic image (coronal view). (D) Postoperative computed tomographic image (axial view).
None
See this image and copyright information in PMC

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