Role of the Esophagus in Surgery for Tracheal Agenesis

Introduction

Tracheal agenesis (TA) is a rare congenital anomaly. Around 150 cases have been reported in the literature to date [1]. Its diagnosis and surgical treatment pose a challenge for surgeons, and the problem of airway access makes this condition almost uniformly fatal. This report describes a case of complete TA in which the middle part of the esophagus was used as a substitute for the airway, the proximal part for pharyngeal drainage and the distal to provide access to deliver feeds into the stomach.

References

• 1 Heimann K, Bartz C, Naami A. et al . Three new cases of congenital agenesis of the trachea.  Eur J Pediatr. 2007;  166 79-82
• 2 Bhatnagar V, Agarwala S, Chattopadhyaya A. et al . Exteriorisation of the distal esophagus in the abdomen in esophageal atresia.  J Pediatr Surg. 1998;  33 489-491
• 3 Payne WA. Congenital absence of the trachea.  Brooklyn Med J. 1900;  14 568
• 4 Dass BB, Nagaraj A, Rao HA. et al . Tracheal agenesis: Report of three cases and review of literature.  Am J Perinatol. 2002;  19 395-399
• 5 Kluth D, Steding G, Seidl W. The embryology of foregut malformations.  J Pediatr Surg. 1987;  22 389-393
• 6 Floyd J, Campbell FJ, Dominy DE. Agenesis of the trachea.  Am Rev Respir Dis. 1962;  86 557-560
• 7 Hedrick MH, Ferro MM, Filly RA. et al . Congenital high airway obstruction syndrome (CHAOS): A potential for perinatal intervention.  J Pediatr Surg. 1994;  29 271-274
• 8 Watanabe T, Okuyama H, Kubot A. et al . A case of tracheal agenesis surviving without mechanical ventilation after esophageal stenting.  J Pediatric Surg. 2008;  43 1906-1908
• 9 Jacobs JP, Quintessenza JA, Andrews T. et al . Tracheal allograft reconstruction: the total North American and worldwide pediatric experiences.  Ann Thorac Surg. 1999;  68 1043-1051
• 10 Neville WE, Bolonowski PJP, Soltanzadek H. Prosthetic reconstruction on the trachea and carina.  J Thorac Cardiovasc Surg. 1976;  72 525-538
• 11 Hubbard AM, Crombleholme TM, Adzick NS. Prenatal MRI evaluation of giant neck masses in preparation for the fetal exit procedure.  Am J Perinatol. 1998;  15 253-257
• 12 Pratap A, Saha GS, Bhattarai BK. et al . Tracheal agenesis type B: further evidence to a lethal congenital tracheal malformation.  J Pediatric Surg. 2007;  42 1284-1287

Correspondence