# Tracheomalacia — GCMD Library living collection

Everything in the library about tracheomalacia — built automatically from dossiers that name it.

Updated: n/a · 12 episodes · 99 cited statements

## Episodes
### Diagnosis & Workup
- [QUAD  #26 - Use of Ultrashort Echo-Time MRI to Measure Tracheomalacia in Neonates with Esophageal Atresia with Dr. Douglas von Allmen](https://origin-library.globalcastmd.com/watch/quad-26-use-of-ultrashort-echo-time-mri-to-measure-tracheomalacia-in-neonates-wi-9953) — video · 5:51 · [machine version](https://origin-library.globalcastmd.com/watch/quad-26-use-of-ultrashort-echo-time-mri-to-measure-tracheomalacia-in-neonates-wi-9953.md)

### Surgical Management
- [Posterior Tracheopexy For Severe Tracheomalacia](https://origin-library.globalcastmd.com/watch/posterior-tracheopexy-for-severe-tracheomalacia-375) — video · 2:18 · [machine version](https://origin-library.globalcastmd.com/watch/posterior-tracheopexy-for-severe-tracheomalacia-375.md)
- [Posterior Tracheopexy during Primary Esophageal Atresia Repair](https://origin-library.globalcastmd.com/watch/posterior-tracheopexy-during-primary-esophageal-atresia-repair-501) — video · [machine version](https://origin-library.globalcastmd.com/watch/posterior-tracheopexy-during-primary-esophageal-atresia-repair-501.md)
- [BOB Ped Surg 2023 - Basma Magdy, PAPSA  - Presentation](https://origin-library.globalcastmd.com/watch/bob-ped-surg-2023-basma-magdy-papsa-presentation-6363) — video · [machine version](https://origin-library.globalcastmd.com/watch/bob-ped-surg-2023-basma-magdy-papsa-presentation-6363.md)
- [QUAD #1: Cervical Tracheopexy with Dr. Alessandro de Alarcon](https://origin-library.globalcastmd.com/watch/quad-1-cervical-tracheopexy-with-dr-alessandro-de-alarcon-7779) — video · 5:26 · [machine version](https://origin-library.globalcastmd.com/watch/quad-1-cervical-tracheopexy-with-dr-alessandro-de-alarcon-7779.md)
- [QUAD #2 Thoracoscopic Tracheopexy with Dr. Aaron Garrison](https://origin-library.globalcastmd.com/watch/quad-2-thoracoscopic-tracheopexy-with-dr-aaron-garrison-7919) — video · 7:36 · [machine version](https://origin-library.globalcastmd.com/watch/quad-2-thoracoscopic-tracheopexy-with-dr-aaron-garrison-7919.md)
- [QUAD #17 - Innominate Artery Compression and Management Through The Neck - Dr. Doug von Allmen](https://origin-library.globalcastmd.com/watch/quad-17-innominate-artery-compression-and-management-through-the-neck-dr-doug-vo-9204) — video · 5:32 · [machine version](https://origin-library.globalcastmd.com/watch/quad-17-innominate-artery-compression-and-management-through-the-neck-dr-doug-vo-9204.md)

### Evidence & Research
- [Tracheomalacia and tracheomegaly in infants and children with congenital diaphragmatic hernia managed with and without fetoscopic endoluminal tracheal occlusion (FETO): a multicentre, retrospective cohort study](https://origin-library.globalcastmd.com/watch/tracheomalacia-and-tracheomegaly-in-infants-and-children-with-congenital-diaphra-9334) — video · 0:59 · [machine version](https://origin-library.globalcastmd.com/watch/tracheomalacia-and-tracheomegaly-in-infants-and-children-with-congenital-diaphra-9334.md)
- [Journal of Pediatric Surgery Article Review: 4th Quarter (Oct-Dec) 2024](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-4th-quarter-2024-9760) — podcast · 18:55 · [machine version](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-4th-quarter-2024-9760.md)
- [Quick Literature Updates Ep 19](https://origin-library.globalcastmd.com/watch/quick-literature-updates-ep-19-10465) — video · 4:27 · [machine version](https://origin-library.globalcastmd.com/watch/quick-literature-updates-ep-19-10465.md)
- [Quick Literature Updates Ep 27](https://origin-library.globalcastmd.com/watch/quick-literature-updates-ep-27-11580) — video · 4:20 · [machine version](https://origin-library.globalcastmd.com/watch/quick-literature-updates-ep-27-11580.md)

### In-Depth Reviews
- [2025 Pediatric Surgery Update Course - Updates in Esophageal Atresia Management](https://origin-library.globalcastmd.com/watch/2025-pediatric-surgery-update-course-updates-in-esophageal-atresia-management-10895) — video · 16:08 · [machine version](https://origin-library.globalcastmd.com/watch/2025-pediatric-surgery-update-course-updates-in-esophageal-atresia-management-10895.md)

## Chapters
- [0:00](https://origin-library.globalcastmd.com/watch/posterior-tracheopexy-for-severe-tracheomalacia-375?t=0) Introduction and Context (Ep 1)
- [0:15](https://origin-library.globalcastmd.com/watch/posterior-tracheopexy-for-severe-tracheomalacia-375?t=15) Study Design and Patient Population (Ep 1)
- [1:05](https://origin-library.globalcastmd.com/watch/posterior-tracheopexy-for-severe-tracheomalacia-375?t=65) Results and Clinical Implications (Ep 1)
- [1:54](https://origin-library.globalcastmd.com/watch/posterior-tracheopexy-for-severe-tracheomalacia-375?t=114) Discussion and Closing (Ep 1)
- [0:00](https://origin-library.globalcastmd.com/watch/posterior-tracheopexy-during-primary-esophageal-atresia-repair-501?t=0) Introduction and context (Ep 2)
- [0:41](https://origin-library.globalcastmd.com/watch/posterior-tracheopexy-during-primary-esophageal-atresia-repair-501?t=41) Technique and patient selection for posterior tracheopexy (Ep 2)
- [1:57](https://origin-library.globalcastmd.com/watch/posterior-tracheopexy-during-primary-esophageal-atresia-repair-501?t=117) Discussion of proactive approach and controversy (Ep 2)
- [0:00](https://origin-library.globalcastmd.com/watch/bob-ped-surg-2023-basma-magdy-papsa-presentation-6363?t=0) Thoracoscopic EA repair with aortopexy for concomitant tracheomalacia: single-center experience (Ep 3)
- [0:00](https://origin-library.globalcastmd.com/watch/quad-1-cervical-tracheopexy-with-dr-alessandro-de-alarcon-7779?t=0) Introduction and Preoperative Workup (Ep 4)
- [1:14](https://origin-library.globalcastmd.com/watch/quad-1-cervical-tracheopexy-with-dr-alessandro-de-alarcon-7779?t=74) Intraoperative Setup and Tools (Ep 4)
- [1:47](https://origin-library.globalcastmd.com/watch/quad-1-cervical-tracheopexy-with-dr-alessandro-de-alarcon-7779?t=107) Surgical Technique and Approach (Ep 4)
- [3:24](https://origin-library.globalcastmd.com/watch/quad-1-cervical-tracheopexy-with-dr-alessandro-de-alarcon-7779?t=204) Outcomes and Follow-up (Ep 4)
- [4:32](https://origin-library.globalcastmd.com/watch/quad-1-cervical-tracheopexy-with-dr-alessandro-de-alarcon-7779?t=272) Summary and Conclusion (Ep 4)
- [0:00](https://origin-library.globalcastmd.com/watch/quad-2-thoracoscopic-tracheopexy-with-dr-aaron-garrison-7919?t=0) Introduction and Evolution of Practice (Ep 5)
- [0:58](https://origin-library.globalcastmd.com/watch/quad-2-thoracoscopic-tracheopexy-with-dr-aaron-garrison-7919?t=58) Rationale for Repair and Preoperative Imaging (Ep 5)
- [2:02](https://origin-library.globalcastmd.com/watch/quad-2-thoracoscopic-tracheopexy-with-dr-aaron-garrison-7919?t=122) Bronchoscopy Classification and Minimally Invasive Advantages (Ep 5)
- [3:21](https://origin-library.globalcastmd.com/watch/quad-2-thoracoscopic-tracheopexy-with-dr-aaron-garrison-7919?t=201) Patient Positioning and Aortopexy Technique (Ep 5)
- [4:28](https://origin-library.globalcastmd.com/watch/quad-2-thoracoscopic-tracheopexy-with-dr-aaron-garrison-7919?t=268) Posterior Tracheopexy Technique (Ep 5)
- [6:07](https://origin-library.globalcastmd.com/watch/quad-2-thoracoscopic-tracheopexy-with-dr-aaron-garrison-7919?t=367) Esophageal Management and Outcomes (Ep 5)
- [6:47](https://origin-library.globalcastmd.com/watch/quad-2-thoracoscopic-tracheopexy-with-dr-aaron-garrison-7919?t=407) Summary and Conclusion (Ep 5)
- [0:00](https://origin-library.globalcastmd.com/watch/quad-17-innominate-artery-compression-and-management-through-the-neck-dr-doug-vo-9204?t=0) Introduction and Historical Context of Innominate Artery Compression (Ep 6)
- [1:30](https://origin-library.globalcastmd.com/watch/quad-17-innominate-artery-compression-and-management-through-the-neck-dr-doug-vo-9204?t=90) Cervical Surgical Approaches in the Literature (Ep 6)
- [2:30](https://origin-library.globalcastmd.com/watch/quad-17-innominate-artery-compression-and-management-through-the-neck-dr-doug-vo-9204?t=150) Case Presentation: Six-Month-Old with Long Gap EA (Ep 6)
- [3:30](https://origin-library.globalcastmd.com/watch/quad-17-innominate-artery-compression-and-management-through-the-neck-dr-doug-vo-9204?t=210) Surgical Technique: Trans-Cervical Innominate Artery Suspension (Ep 6)
- [4:30](https://origin-library.globalcastmd.com/watch/quad-17-innominate-artery-compression-and-management-through-the-neck-dr-doug-vo-9204?t=270) Outcomes and Patient Selection Criteria (Ep 6)
- [0:00](https://origin-library.globalcastmd.com/watch/tracheomalacia-and-tracheomegaly-in-infants-and-children-with-congenital-diaphra-9334?t=0) Introduction and Study Design (Ep 7)
- [0:22](https://origin-library.globalcastmd.com/watch/tracheomalacia-and-tracheomegaly-in-infants-and-children-with-congenital-diaphra-9334?t=22) Key Findings (Ep 7)
- [0:46](https://origin-library.globalcastmd.com/watch/tracheomalacia-and-tracheomegaly-in-infants-and-children-with-congenital-diaphra-9334?t=46) Conclusion (Ep 7)
- [0:04](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-4th-quarter-2024-9760?t=4) Locum Tenens in Pediatric Surgery: APSA Position Statement and Practice Guidelines (Ep 8)
- [6:53](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-4th-quarter-2024-9760?t=413) Preoperative Rigid Bronchoscopy for Tracheomalacia Diagnosis in Esophageal Atresia (Ep 8)
- [11:02](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-4th-quarter-2024-9760?t=662) Same-Day Discharge After Elective Laparoscopic Gastrostomy Tube Placement (Ep 8)
- [17:52](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-4th-quarter-2024-9760?t=1072) Episode Recap and Closing (Ep 8)
- [0:00](https://origin-library.globalcastmd.com/watch/quad-26-use-of-ultrashort-echo-time-mri-to-measure-tracheomalacia-in-neonates-wi-9953?t=0) Introduction to ultrashort echo-time MRI for tracheomalacia evaluation (Ep 9)
- [2:00](https://origin-library.globalcastmd.com/watch/quad-26-use-of-ultrashort-echo-time-mri-to-measure-tracheomalacia-in-neonates-wi-9953?t=120) Study design and methodology for measuring tracheal eccentricity (Ep 9)
- [3:00](https://origin-library.globalcastmd.com/watch/quad-26-use-of-ultrashort-echo-time-mri-to-measure-tracheomalacia-in-neonates-wi-9953?t=180) Results comparing short-gap versus long-gap esophageal atresia (Ep 9)
- [4:30](https://origin-library.globalcastmd.com/watch/quad-26-use-of-ultrashort-echo-time-mri-to-measure-tracheomalacia-in-neonates-wi-9953?t=270) Clinical implications and summary (Ep 9)
- [0:00](https://origin-library.globalcastmd.com/watch/quick-literature-updates-ep-19-10465?t=0) Introduction and APSA Peer Support Program (Ep 10)
- [1:43](https://origin-library.globalcastmd.com/watch/quick-literature-updates-ep-19-10465?t=103) Tracheomalacia in CDH with and without FETO (Ep 10)
- [3:02](https://origin-library.globalcastmd.com/watch/quick-literature-updates-ep-19-10465?t=182) Image-Guided vs Surgical Biopsy for Neuroblastoma (Ep 10)
- [0:00](https://origin-library.globalcastmd.com/watch/2025-pediatric-surgery-update-course-updates-in-esophageal-atresia-management-10895?t=0) Introduction and Session Transition (Ep 11)

## Statements
Every statement is attributed, typed, and timestamped; the link is the citation.
- Tracheomalacia was 5% more common in tracheal occluded infants with 4% more cases — Carlos Colunga (clinical) [Ep 7 · 0:24](https://origin-library.globalcastmd.com/watch/tracheomalacia-and-tracheomegaly-in-infants-and-children-with-congenital-diaphra-9334?t=24)
- Tracheomalacia symptoms typically receded within 55 months in FETO-treated infants — Carlos Colunga (clinical) [Ep 7 · 0:29](https://origin-library.globalcastmd.com/watch/tracheomalacia-and-tracheomegaly-in-infants-and-children-with-congenital-diaphra-9334?t=29)
- FETO-treated infants showed a larger trachea, approximately 31% wider — Carlos Colunga (clinical) [Ep 7 · 0:33](https://origin-library.globalcastmd.com/watch/tracheomalacia-and-tracheomegaly-in-infants-and-children-with-congenital-diaphra-9334?t=33)
- 37% of tracheally occluded cases retained metallic balloon components — Carlos Colunga (clinical) [Ep 7 · 0:33](https://origin-library.globalcastmd.com/watch/tracheomalacia-and-tracheomegaly-in-infants-and-children-with-congenital-diaphra-9334?t=33)
- No significant complications were reported from retained metallic balloon components — Carlos Colunga (clinical) [Ep 7 · 0:33](https://origin-library.globalcastmd.com/watch/tracheomalacia-and-tracheomegaly-in-infants-and-children-with-congenital-diaphra-9334?t=33)
- Tracheal occlusion is effective in promoting lung growth — Carlos Colunga (clinical) [Ep 7 · 0:46](https://origin-library.globalcastmd.com/watch/tracheomalacia-and-tracheomegaly-in-infants-and-children-with-congenital-diaphra-9334?t=46)
- FETO is associated with a higher risk of tracheomalacia — Carlos Colunga (clinical) [Ep 7 · 0:46](https://origin-library.globalcastmd.com/watch/tracheomalacia-and-tracheomegaly-in-infants-and-children-with-congenital-diaphra-9334?t=46)
- Most cases of FETO-associated tracheomalacia resolve and do not appear to have long-term effects — Carlos Colunga (clinical) [Ep 7 · 0:46](https://origin-library.globalcastmd.com/watch/tracheomalacia-and-tracheomegaly-in-infants-and-children-with-congenital-diaphra-9334?t=46)
- Cincinnati Children's typically uses a combined cervical and thoracic approach for esophageal atresia cases. — Alessandro de Alarcon (clinical) [Ep 4 · 0:49](https://origin-library.globalcastmd.com/watch/quad-1-cervical-tracheopexy-with-dr-alessandro-de-alarcon-7779?t=49)
- Required intraoperative equipment includes a neck tray, MLB tray, and Maloney dilators or NG tubes. — Alessandro de Alarcon (clinical) [Ep 4 · 1:15](https://origin-library.globalcastmd.com/watch/quad-1-cervical-tracheopexy-with-dr-alessandro-de-alarcon-7779?t=75)
- Flexible bronchoscopy during the operation is key, and endotracheal tube placement must allow visualization during the procedure. — Alessandro de Alarcon (clinical) [Ep 4 · 1:21](https://origin-library.globalcastmd.com/watch/quad-1-cervical-tracheopexy-with-dr-alessandro-de-alarcon-7779?t=81)
- Nasotracheal intubation is often used with the cuff positioned high, sometimes almost at the glottis. — Alessandro de Alarcon (clinical) [Ep 4 · 1:29](https://origin-library.globalcastmd.com/watch/quad-1-cervical-tracheopexy-with-dr-alessandro-de-alarcon-7779?t=89)
- A NIM tube is preferred when possible to prevent injury to recurrent nerves or provide awareness when approaching them. — Alessandro de Alarcon (clinical) [Ep 4 · 1:39](https://origin-library.globalcastmd.com/watch/quad-1-cervical-tracheopexy-with-dr-alessandro-de-alarcon-7779?t=99)
- The surgical approach uses subplatysmal flaps and addresses anterior compression as needed. — Alessandro de Alarcon (clinical) [Ep 4 · 1:55](https://origin-library.globalcastmd.com/watch/quad-1-cervical-tracheopexy-with-dr-alessandro-de-alarcon-7779?t=115)
- Aortopexy and innominate artery pexy can be added at the same time as the cervical procedure. — Alessandro de Alarcon (clinical) [Ep 4 · 2:09](https://origin-library.globalcastmd.com/watch/quad-1-cervical-tracheopexy-with-dr-alessandro-de-alarcon-7779?t=129)
- The Cincinnati team has learned not to be afraid of mobilizing the esophagus, which is important for the procedure. — Alessandro de Alarcon (opinion) [Ep 4 · 2:29](https://origin-library.globalcastmd.com/watch/quad-1-cervical-tracheopexy-with-dr-alessandro-de-alarcon-7779?t=149)
- Stitches are sometimes placed in the trachea to pull it up and out of the way for visualization of the posterior aspect and spine. — Alessandro de Alarcon (clinical) [Ep 4 · 2:54](https://origin-library.globalcastmd.com/watch/quad-1-cervical-tracheopexy-with-dr-alessandro-de-alarcon-7779?t=174)
- The team uses 3-0 prolene sutures and places all stitches before securing them down. — Alessandro de Alarcon (clinical) [Ep 4 · 3:15](https://origin-library.globalcastmd.com/watch/quad-1-cervical-tracheopexy-with-dr-alessandro-de-alarcon-7779?t=195)
- Suture placement is performed under spontaneous ventilation conditions. — Alessandro de Alarcon (clinical) [Ep 4 · 3:15](https://origin-library.globalcastmd.com/watch/quad-1-cervical-tracheopexy-with-dr-alessandro-de-alarcon-7779?t=195)
- A patient who had prior thoracoscopic tracheopexy with dysphagia from torqued esophagus underwent the combined approach and became symptom-free. — Alessandro de Alarcon (clinical) [Ep 4 · 3:33](https://origin-library.globalcastmd.com/watch/quad-1-cervical-tracheopexy-with-dr-alessandro-de-alarcon-7779?t=213)
- Outcome measures include follow-up endoscopy, pulmonary function tests when patients are old enough, and imaging. — Alessandro de Alarcon (clinical) [Ep 4 · 4:00](https://origin-library.globalcastmd.com/watch/quad-1-cervical-tracheopexy-with-dr-alessandro-de-alarcon-7779?t=240)
- At 36 months follow-up, imaging may still show tracheomalacia, but patients can be symptomatically better. — Alessandro de Alarcon (clinical) [Ep 4 · 4:09](https://origin-library.globalcastmd.com/watch/quad-1-cervical-tracheopexy-with-dr-alessandro-de-alarcon-7779?t=249)
- The team is still learning what measures should define good versus bad outcomes. — Alessandro de Alarcon (opinion) [Ep 4 · 4:15](https://origin-library.globalcastmd.com/watch/quad-1-cervical-tracheopexy-with-dr-alessandro-de-alarcon-7779?t=255)
- Managing complications including swallowing dysfunction and vocal fold paralysis is part of postoperative care. — Alessandro de Alarcon (clinical) [Ep 4 · 4:26](https://origin-library.globalcastmd.com/watch/quad-1-cervical-tracheopexy-with-dr-alessandro-de-alarcon-7779?t=266)
- Pediatric surgery trainees were initially told that tracheomalacia is something that kids will grow out of and will get better. — Aaron Garrison (opinion) [Ep 5 · 0:58](https://origin-library.globalcastmd.com/watch/quad-2-thoracoscopic-tracheopexy-with-dr-aaron-garrison-7919?t=58)
- Recent data has shown that there are long term consequences for soiling into the lungs and having chronic lung aspiration, which over time is detrimental. — Aaron Garrison (clinical) [Ep 5 · 1:08](https://origin-library.globalcastmd.com/watch/quad-2-thoracoscopic-tracheopexy-with-dr-aaron-garrison-7919?t=68)
- Preoperative dynamic reconstruction studies give a lot of information for determining which procedure is best for each patient. — Aaron Garrison (clinical) [Ep 5 · 1:26](https://origin-library.globalcastmd.com/watch/quad-2-thoracoscopic-tracheopexy-with-dr-aaron-garrison-7919?t=86)
- Dynamic expiratory films show what you need to see with the airway that inspiratory films alone do not reveal. — Aaron Garrison (clinical) [Ep 5 · 1:31](https://origin-library.globalcastmd.com/watch/quad-2-thoracoscopic-tracheopexy-with-dr-aaron-garrison-7919?t=91)
- Surgeons always look for the thymus and make sure that there is enough tissue to remove to be able to bring the trachea up anteriorly. — Aaron Garrison (clinical) [Ep 5 · 1:55](https://origin-library.globalcastmd.com/watch/quad-2-thoracoscopic-tracheopexy-with-dr-aaron-garrison-7919?t=115)
- The classification system for tracheomalacia is in evolution, and trying to describe what is mild or severe or moderate is a little bit challenging. — Aaron Garrison (opinion) [Ep 5 · 2:17](https://origin-library.globalcastmd.com/watch/quad-2-thoracoscopic-tracheopexy-with-dr-aaron-garrison-7919?t=137)
- The biggest benefit of minimally invasive approach is visualization and exposure. — Aaron Garrison (opinion) [Ep 5 · 2:34](https://origin-library.globalcastmd.com/watch/quad-2-thoracoscopic-tracheopexy-with-dr-aaron-garrison-7919?t=154)
- Disadvantages of minimally invasive approach include that it takes longer to learn and is more uncomfortable to learn. — Aaron Garrison (opinion) [Ep 5 · 2:39](https://origin-library.globalcastmd.com/watch/quad-2-thoracoscopic-tracheopexy-with-dr-aaron-garrison-7919?t=159)
- Anesthesia colleagues are sometimes hesitant to allow thoracoscopic cases to go on a little bit longer. — Aaron Garrison (opinion) [Ep 5 · 2:42](https://origin-library.globalcastmd.com/watch/quad-2-thoracoscopic-tracheopexy-with-dr-aaron-garrison-7919?t=162)
- For anterior mediastinal work, babies are positioned with the arm up and a bump underneath so that there is access to the axilla and anteriorly. — Aaron Garrison (clinical) [Ep 5 · 3:33](https://origin-library.globalcastmd.com/watch/quad-2-thoracoscopic-tracheopexy-with-dr-aaron-garrison-7919?t=213)
- The goal of aortopexy is to suspend the aorta. — Aaron Garrison (clinical) [Ep 5 · 3:51](https://origin-library.globalcastmd.com/watch/quad-2-thoracoscopic-tracheopexy-with-dr-aaron-garrison-7919?t=231)
- The first step in aortopexy is taking out the thymus, finding the innominate junction, and then identifying the arch of the aorta. — Aaron Garrison (clinical) [Ep 5 · 3:54](https://origin-library.globalcastmd.com/watch/quad-2-thoracoscopic-tracheopexy-with-dr-aaron-garrison-7919?t=234)
- If you go up too high during aortopexy, then you are doing a pericardiopexy and it is not quite as successful or durable. — Aaron Garrison (clinical) [Ep 5 · 4:10](https://origin-library.globalcastmd.com/watch/quad-2-thoracoscopic-tracheopexy-with-dr-aaron-garrison-7919?t=250)
- The goal of posterior tracheopexy is taking the anterior spinal ligament and fixing it to the posterior membranous trachea. — Aaron Garrison (clinical) [Ep 5 · 4:45](https://origin-library.globalcastmd.com/watch/quad-2-thoracoscopic-tracheopexy-with-dr-aaron-garrison-7919?t=285)
- The area of floppy membrane is distal to the dilated pouch usually. — Aaron Garrison (clinical) [Ep 5 · 4:56](https://origin-library.globalcastmd.com/watch/quad-2-thoracoscopic-tracheopexy-with-dr-aaron-garrison-7919?t=296)
- Surgeons can make an indent on the posterior wall of the trachea, and pulmonologists can see it pop up on their bronchoscopy to help guide suture placement. — Aaron Garrison (clinical) [Ep 5 · 5:09](https://origin-library.globalcastmd.com/watch/quad-2-thoracoscopic-tracheopexy-with-dr-aaron-garrison-7919?t=309)
- It usually takes about 2 or 3 sutures for posterior tracheopexy, leaving enough space for the esophagus to come through. — Aaron Garrison (clinical) [Ep 5 · 5:43](https://origin-library.globalcastmd.com/watch/quad-2-thoracoscopic-tracheopexy-with-dr-aaron-garrison-7919?t=343)
- Using the knot pusher and tension suture is helpful during tracheopexy. — Aaron Garrison (opinion) [Ep 5 · 5:48](https://origin-library.globalcastmd.com/watch/quad-2-thoracoscopic-tracheopexy-with-dr-aaron-garrison-7919?t=348)
- Getting the suture to roll through the anterior spinal ligament is the hardest part and is pretty challenging. — Aaron Garrison (opinion) [Ep 5 · 5:58](https://origin-library.globalcastmd.com/watch/quad-2-thoracoscopic-tracheopexy-with-dr-aaron-garrison-7919?t=358)
- There are times when the esophagus is put to the left of the trachea, and times when it is put to the right of the trachea. — Aaron Garrison (clinical) [Ep 5 · 6:20](https://origin-library.globalcastmd.com/watch/quad-2-thoracoscopic-tracheopexy-with-dr-aaron-garrison-7919?t=380)
- Dr. Garrison always worries a little bit about dysphagia when repositioning the esophagus, but it is not something he has seen a ton of. — Aaron Garrison (opinion) [Ep 5 · 6:26](https://origin-library.globalcastmd.com/watch/quad-2-thoracoscopic-tracheopexy-with-dr-aaron-garrison-7919?t=386)
- There is a need for standardization in the treatment of tracheomalacia. — Ian Glenn (opinion) [Ep 1 · 1:58](https://origin-library.globalcastmd.com/watch/posterior-tracheopexy-for-severe-tracheomalacia-375?t=118)
- Up to 20% of patients with EA will have a laryngeal cleft. — Matt Dellinger (epidemiological) [Ep 11 · 5:30](https://origin-library.globalcastmd.com/watch/2025-pediatric-surgery-update-course-updates-in-esophageal-atresia-management-10895?t=330)
- Preoperative bronchoscopy has only approximately 50% sensitivity for predicting clinically significant tracheomalacia; about half of patients without evidence of tracheomalacia on preoperative bronchoscopy will go on to develop clinically significant tracheomalacia. — Matt Dellinger (clinical) [Ep 11 · 9:00](https://origin-library.globalcastmd.com/watch/2025-pediatric-surgery-update-course-updates-in-esophageal-atresia-management-10895?t=540)
- Posterior tracheopexy involves placing horizontal mattress sutures in the posterior membranous portion of the trachea under flexible bronchoscopic guidance and suturing them to the anterior longitudinal ligament of the spine. — Matt Dellinger (clinical) [Ep 11 · 11:20](https://origin-library.globalcastmd.com/watch/2025-pediatric-surgery-update-course-updates-in-esophageal-atresia-management-10895?t=680)
- Recurrent laryngeal nerve injury occurs in 11% of EA repair patients overall, which may be an underestimation. — Matt Dellinger (epidemiological) [Ep 11 · 14:30](https://origin-library.globalcastmd.com/watch/2025-pediatric-surgery-update-course-updates-in-esophageal-atresia-management-10895?t=870)
- In H-type EA repairs, which are often addressed through a cervical surgical approach, recurrent laryngeal nerve injury rates are up to 50%. — Matt Dellinger (epidemiological) [Ep 11 · 14:45](https://origin-library.globalcastmd.com/watch/2025-pediatric-surgery-update-course-updates-in-esophageal-atresia-management-10895?t=885)
- Injury rates for recurrent laryngeal nerve may be higher during thoracoscopic EA repair when mobilizing the proximal pouch. — Matt Dellinger (clinical) [Ep 11 · 15:00](https://origin-library.globalcastmd.com/watch/2025-pediatric-surgery-update-course-updates-in-esophageal-atresia-management-10895?t=900)
- Modifying nerve monitoring electrodes to small endotracheal tubes for use in EA repair is technically challenging and has a learning curve. — Matt Dellinger (clinical) [Ep 11 · 15:40](https://origin-library.globalcastmd.com/watch/2025-pediatric-surgery-update-course-updates-in-esophageal-atresia-management-10895?t=940)
- Unusual fistula locations can occur in EA, including peck bronchus or main stem bronchus fistula. — Matt Dellinger (clinical) [Ep 11 · 5:20](https://origin-library.globalcastmd.com/watch/2025-pediatric-surgery-update-course-updates-in-esophageal-atresia-management-10895?t=320)
- Rare findings on preoperative bronchoscopy include subglottic or molecular cysts that may have implications for respiratory support and postoperative course. — Matt Dellinger (clinical) [Ep 11 · 5:40](https://origin-library.globalcastmd.com/watch/2025-pediatric-surgery-update-course-updates-in-esophageal-atresia-management-10895?t=340)
- There was no regulation or recommendations for practicing pediatric surgeons on how to engage with the locum tenens market prior to APSA's guidelines — Tony Escobar (guideline) [Ep 8 · 2:52](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-4th-quarter-2024-9760?t=172)
- Locum tenens agencies facilitate attainment of state medical license, privileges and credentials at hiring institutions, and negotiate surgeon compensation including travel and lodging — Adi Fahy (clinical) [Ep 8 · 3:30](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-4th-quarter-2024-9760?t=210)
- APSA is developing a breakout group to provide ongoing support to pediatric surgeons working in locum tenens roles — Tony Escobar (guideline) [Ep 8 · 5:53](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-4th-quarter-2024-9760?t=353)
- Tracheomalacia in esophageal atresia patients causes respiratory issues including stridor, wheezing, harsh barking cough, and lower respiratory infections — Anna Flirt van Gaal (clinical) [Ep 8 · 7:02](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-4th-quarter-2024-9760?t=422)
- In up to a third of esophageal atresia cases, tracheomalacia can lead to recurrent respiratory insufficiency and severe respiratory events — Anna Flirt van Gaal (epidemiological) [Ep 8 · 7:30](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-4th-quarter-2024-9760?t=450)
- There is no consensus on tracheal assessment during diagnosis of esophageal atresia — Anna Flirt van Gaal (guideline) [Ep 8 · 7:30](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-4th-quarter-2024-9760?t=450)
- In the Dutch center, patients undergo preoperative tracheal bronchoscopy as standard of care, but postoperative bronchoscopy is performed only when clinically indicated — Anna Flirt van Gaal (clinical) [Ep 8 · 7:48](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-4th-quarter-2024-9760?t=468)
- The 50% sensitivity finding suggests it might be advisable to avoid primary therapeutic intervention at time of esophageal atresia repair and only treat patients who develop symptoms — Mikko Pakarinen (opinion) [Ep 8 · 9:30](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-4th-quarter-2024-9760?t=570)
- A prospective study with standardized assessments and larger patient groups is needed to clarify the role of bronchoscopy in tracheomalacia assessment — Anna Flirt van Gaal (opinion) [Ep 8 · 10:16](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-4th-quarter-2024-9760?t=616)
- During the pandemic, limited hospital beds led to consideration of same-day discharge for gastrostomy patients to optimize resource use — Ben Hamm (clinical) [Ep 8 · 12:18](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-4th-quarter-2024-9760?t=738)
- NSQIP pediatric registry includes more than 150 participating hospitals across 44 states and 7 countries — Pablo Laje (epidemiological) [Ep 8 · 13:06](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-4th-quarter-2024-9760?t=786)
- The study identified approximately 6000 pediatric patients who underwent elective gastrostomy tube placement from 2017 to 2021 in the NSQIP database — John Woodward (epidemiological) [Ep 8 · 13:24](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-4th-quarter-2024-9760?t=804)
- About 5% of gastrostomy patients were discharged the same day as surgery — John Woodward (epidemiological) [Ep 8 · 14:10](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-4th-quarter-2024-9760?t=850)
- Same-day discharge rates increased from 2.7% in 2017 to 6.3% in 2021, representing a doubling of the rate — John Woodward (epidemiological) [Ep 8 · 14:30](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-4th-quarter-2024-9760?t=870)
- There were no differences in readmission or reoperation rates between same-day discharge and 1-2 day discharge cohorts — John Woodward (clinical) [Ep 8 · 15:20](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-4th-quarter-2024-9760?t=920)
- Implementing same-day discharge requires major process changes including advance family education, nutrition partnership for feeding plans, and setup of pumps and supplies — Ben Hamm (clinical) [Ep 8 · 15:54](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-4th-quarter-2024-9760?t=954)
- From every point of view, one less day in hospital is a win for the patient, family, and hospital — Pablo Laje (opinion) [Ep 8 · 16:28](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-4th-quarter-2024-9760?t=988)
- The study included EA patients diagnosed with moderate to severe tracheomalacia by immediate preoperative rigid bronchoscopy. — Basma Magdy (clinical) [Ep 3 · 0:00](https://origin-library.globalcastmd.com/watch/bob-ped-surg-2023-basma-magdy-papsa-presentation-6363?t=0)
- Tracheomalacia assessment was performed in two phases of breathing: spontaneous breathing and while applying a Valsalva maneuver or applying negative pressure. — Basma Magdy (clinical) [Ep 3 · 0:00](https://origin-library.globalcastmd.com/watch/bob-ped-surg-2023-basma-magdy-papsa-presentation-6363?t=0)
- Bronchoscopic assessment included vocal cords, subglottic area, position of the trachea, posterior membrane ratio to whole circumference, cartilage shape, and tracheal collapse. — Basma Magdy (clinical) [Ep 3 · 0:00](https://origin-library.globalcastmd.com/watch/bob-ped-surg-2023-basma-magdy-papsa-presentation-6363?t=0)
- 24 patients met inclusion criteria during the study period (2019-2022). — Basma Magdy (epidemiological) [Ep 3 · 0:00](https://origin-library.globalcastmd.com/watch/bob-ped-surg-2023-basma-magdy-papsa-presentation-6363?t=0)
- The procedure was completed in 22 of 24 patients. — Basma Magdy (clinical) [Ep 3 · 0:00](https://origin-library.globalcastmd.com/watch/bob-ped-surg-2023-basma-magdy-papsa-presentation-6363?t=0)
- Mean operative time was 118 minutes and mean aortopexy time was 15 minutes. — Basma Magdy (clinical) [Ep 3 · 0:00](https://origin-library.globalcastmd.com/watch/bob-ped-surg-2023-basma-magdy-papsa-presentation-6363?t=0)
- 17 patients were discharged alive with a median postoperative hospital stay of 9 days. — Basma Magdy (clinical) [Ep 3 · 0:00](https://origin-library.globalcastmd.com/watch/bob-ped-surg-2023-basma-magdy-papsa-presentation-6363?t=0)
- Six patients developed anastomotic leak. — Basma Magdy (clinical) [Ep 3 · 0:00](https://origin-library.globalcastmd.com/watch/bob-ped-surg-2023-basma-magdy-papsa-presentation-6363?t=0)
- Seven patients died in the early postoperative period. — Basma Magdy (clinical) [Ep 3 · 0:00](https://origin-library.globalcastmd.com/watch/bob-ped-surg-2023-basma-magdy-papsa-presentation-6363?t=0)
- 17 patients were followed up with a mean follow-up period of 26 months. — Basma Magdy (clinical) [Ep 3 · 0:00](https://origin-library.globalcastmd.com/watch/bob-ped-surg-2023-basma-magdy-papsa-presentation-6363?t=0)
- Seven patients developed symptoms in the form of cough, choking, and difficulty swallowing during follow-up. — Basma Magdy (clinical) [Ep 3 · 0:00](https://origin-library.globalcastmd.com/watch/bob-ped-surg-2023-basma-magdy-papsa-presentation-6363?t=0)
- Symptoms were analyzed by esophagogram and bronchoscopy as needed. — Basma Magdy (clinical) [Ep 3 · 0:00](https://origin-library.globalcastmd.com/watch/bob-ped-surg-2023-basma-magdy-papsa-presentation-6363?t=0)
- Five patients had symptoms due to anastomotic stricture and improved after dilatation. — Basma Magdy (clinical) [Ep 3 · 0:00](https://origin-library.globalcastmd.com/watch/bob-ped-surg-2023-basma-magdy-papsa-presentation-6363?t=0)
- Two patients had symptoms due to development of recurrent tracheomalacia, which was still present in one of these patients. — Basma Magdy (clinical) [Ep 3 · 0:00](https://origin-library.globalcastmd.com/watch/bob-ped-surg-2023-basma-magdy-papsa-presentation-6363?t=0)
- The remaining patients (after excluding those with stricture or recurrent tracheomalacia) were considered to have successful aortopexy. — Basma Magdy (clinical) [Ep 3 · 0:00](https://origin-library.globalcastmd.com/watch/bob-ped-surg-2023-basma-magdy-papsa-presentation-6363?t=0)
- The main limitations of this study are the small number of patients and the short follow-up period. — Basma Magdy (opinion) [Ep 3 · 0:00](https://origin-library.globalcastmd.com/watch/bob-ped-surg-2023-basma-magdy-papsa-presentation-6363?t=0)
- Attention given to tracheomalacia by surgeons may improve quality of life in EA patients. — Basma Magdy (opinion) [Ep 3 · 0:00](https://origin-library.globalcastmd.com/watch/bob-ped-surg-2023-basma-magdy-papsa-presentation-6363?t=0)
- Preoperative determination of the need for aortopexy may alleviate chronic respiratory conditions and decrease the risk of future surgical intervention. — Basma Magdy (opinion) [Ep 3 · 0:00](https://origin-library.globalcastmd.com/watch/bob-ped-surg-2023-basma-magdy-papsa-presentation-6363?t=0)
- Esophageal atresia is a foregut anomaly, so usually the trachea is also affected. — Stephan Derhauf (clinical) [Ep 2 · 0:41](https://origin-library.globalcastmd.com/watch/posterior-tracheopexy-during-primary-esophageal-atresia-repair-501?t=41)
- At bronchoscopy, you can assess the site of the TE fistula and whether it's more an anterior problem or a posterior problem. — Stephan Derhauf (clinical) [Ep 2 · 0:41](https://origin-library.globalcastmd.com/watch/posterior-tracheopexy-during-primary-esophageal-atresia-repair-501?t=41)
- If there is more than 2/3 lumen occlusion, especially from the posterior side, then you should consider doing posterior tracheopexy. — Stephan Derhauf (clinical) [Ep 2 · 0:41](https://origin-library.globalcastmd.com/watch/posterior-tracheopexy-during-primary-esophageal-atresia-repair-501?t=41)
- Four patients operated last year all had moderate to severe tracheomalacia at bronchoscopy, especially posterior membranous intrusion of the lumen. — Stephan Derhauf (clinical) [Ep 2 · 0:41](https://origin-library.globalcastmd.com/watch/posterior-tracheopexy-during-primary-esophageal-atresia-repair-501?t=41)
- Patients were operated during thoracoscopic esophageal atresia surgery with pexy of the posterior wall towards the spinal ligament, then anastomosis of both ends. — Stephan Derhauf (clinical) [Ep 2 · 0:41](https://origin-library.globalcastmd.com/watch/posterior-tracheopexy-during-primary-esophageal-atresia-repair-501?t=41)
- The technique is done with non-absorbable suturing. — Stephan Derhauf (clinical) [Ep 2 · 0:41](https://origin-library.globalcastmd.com/watch/posterior-tracheopexy-during-primary-esophageal-atresia-repair-501?t=41)
- All four patients recovered well, and none of them had any respiratory symptoms after surgery. — Stephan Derhauf (clinical) [Ep 2 · 0:41](https://origin-library.globalcastmd.com/watch/posterior-tracheopexy-during-primary-esophageal-atresia-repair-501?t=41)
- This technique only takes 6 minutes per suture, and two or three sutures are placed. — Stephan Derhauf (clinical) [Ep 2 · 0:41](https://origin-library.globalcastmd.com/watch/posterior-tracheopexy-during-primary-esophageal-atresia-repair-501?t=41)
- Whether routine posterior tracheopexy during primary esophageal atresia repair is right or wrong is uncertain and represents a very hot topic. — Stephan Derhauf (opinion) [Ep 2 · 2:24](https://origin-library.globalcastmd.com/watch/posterior-tracheopexy-during-primary-esophageal-atresia-repair-501?t=144)

## Host summaries
Recaps by a host of what the experts said — not the host's own clinical position.
- Preoperative testing includes dynamic CT imaging, pulmonary function tests, microlaryngoscopy and bronchoscopy, and flexible bronchoscopy. — Todd Ponsky summarizes what Dr. Alessandro de Alarcon said [Ep 4 · 0:55](https://origin-library.globalcastmd.com/watch/quad-1-cervical-tracheopexy-with-dr-alessandro-de-alarcon-7779?t=55)
- The cervical approach can assist thoracoscopic procedures by removing residual or regrown large thymus tissue. — Todd Ponsky summarizes what Dr. Alessandro de Alarcon said [Ep 4 · 2:01](https://origin-library.globalcastmd.com/watch/quad-1-cervical-tracheopexy-with-dr-alessandro-de-alarcon-7779?t=121)
- In the lateral approach, the surgical team works on the side of the airway to find the esophagus. — Todd Ponsky summarizes what Dr. Alessandro de Alarcon said [Ep 4 · 2:19](https://origin-library.globalcastmd.com/watch/quad-1-cervical-tracheopexy-with-dr-alessandro-de-alarcon-7779?t=139)
- Pediatric surgeons identify the recurrent nerve for the ENT team to help prevent injury. — Todd Ponsky summarizes what Dr. Alessandro de Alarcon said [Ep 4 · 2:23](https://origin-library.globalcastmd.com/watch/quad-1-cervical-tracheopexy-with-dr-alessandro-de-alarcon-7779?t=143)
- The esophagus is mobilized above the level where the team aims to perform the pexy, making suture placement easier. — Todd Ponsky summarizes what Dr. Alessandro de Alarcon said [Ep 4 · 2:43](https://origin-library.globalcastmd.com/watch/quad-1-cervical-tracheopexy-with-dr-alessandro-de-alarcon-7779?t=163)
- A pulmonologist assists with flexible endoscopy through the endotracheal tube to visualize inside the trachea while stitches are placed. — Todd Ponsky summarizes what Dr. Alessandro de Alarcon said [Ep 4 · 3:02](https://origin-library.globalcastmd.com/watch/quad-1-cervical-tracheopexy-with-dr-alessandro-de-alarcon-7779?t=182)
- The combined approach is valuable for complicated cases or patients needing additional operations for symptom relief. — Todd Ponsky summarizes what Dr. Alessandro de Alarcon said [Ep 4 · 3:24](https://origin-library.globalcastmd.com/watch/quad-1-cervical-tracheopexy-with-dr-alessandro-de-alarcon-7779?t=204)
- Otolaryngology involvement is important both during the procedure and in follow-up due to potential complications. — Todd Ponsky summarizes what Dr. Alessandro de Alarcon said [Ep 4 · 4:32](https://origin-library.globalcastmd.com/watch/quad-1-cervical-tracheopexy-with-dr-alessandro-de-alarcon-7779?t=272)
- Several years ago, the approach was that patients with tracheomalacia would undergo aortopexy. — Em Gootee summarizes what Dr. Aaron Garrison said [Ep 5 · 0:36](https://origin-library.globalcastmd.com/watch/quad-2-thoracoscopic-tracheopexy-with-dr-aaron-garrison-7919?t=36)
- In the last 4 to 5 years, it has become standard practice to determine which patients will respond best to tracheopexy versus aortopexy. — Em Gootee summarizes what Dr. Aaron Garrison said [Ep 5 · 0:43](https://origin-library.globalcastmd.com/watch/quad-2-thoracoscopic-tracheopexy-with-dr-aaron-garrison-7919?t=43)
- Part of the workup is making sure that there is space to anteriorly suspend the aorta so that the trachea diameter can actually be made larger. — Em Gootee summarizes what Dr. Aaron Garrison said [Ep 5 · 1:45](https://origin-library.globalcastmd.com/watch/quad-2-thoracoscopic-tracheopexy-with-dr-aaron-garrison-7919?t=105)
- Preoperative bronchoscopy gives the surgical team an idea of internal anatomy, which can assist in classifying the degree of tracheomalacia prior to surgical intervention. — Em Gootee summarizes what Dr. Aaron Garrison said [Ep 5 · 2:02](https://origin-library.globalcastmd.com/watch/quad-2-thoracoscopic-tracheopexy-with-dr-aaron-garrison-7919?t=122)
- A paper in Anesthesiology looked at open, thoracoscopic, and converted patients and found no difference in blood gases and metabolic derangements during surgery. — Aaron Garrison summarizing a resource [Ep 5 · 3:03](https://origin-library.globalcastmd.com/watch/quad-2-thoracoscopic-tracheopexy-with-dr-aaron-garrison-7919?t=183)
- The same study found no difference when looking at blood pressure with acidosis and hypoxia between open and thoracoscopic approaches. — Aaron Garrison summarizing a resource [Ep 5 · 3:17](https://origin-library.globalcastmd.com/watch/quad-2-thoracoscopic-tracheopexy-with-dr-aaron-garrison-7919?t=197)
- When using a thoracoscopic approach, correct positioning is the key to success. — Em Gootee summarizes what Dr. Aaron Garrison said [Ep 5 · 3:23](https://origin-library.globalcastmd.com/watch/quad-2-thoracoscopic-tracheopexy-with-dr-aaron-garrison-7919?t=203)
- It is best to use gravity to advantage as it aids in retracting the lungs and trachea placement. — Em Gootee summarizes what Dr. Aaron Garrison said [Ep 5 · 3:27](https://origin-library.globalcastmd.com/watch/quad-2-thoracoscopic-tracheopexy-with-dr-aaron-garrison-7919?t=207)
- Opening the pericardium and finding the area at the pericardial-adventitial junction to suspend is the key point of aortopexy. — Em Gootee summarizes what Dr. Aaron Garrison said [Ep 5 · 4:01](https://origin-library.globalcastmd.com/watch/quad-2-thoracoscopic-tracheopexy-with-dr-aaron-garrison-7919?t=241)
- Passing suture transternally is preferred with the aortopexy approach, though it can be technically difficult. — Em Gootee summarizes what Dr. Aaron Garrison said [Ep 5 · 4:16](https://origin-library.globalcastmd.com/watch/quad-2-thoracoscopic-tracheopexy-with-dr-aaron-garrison-7919?t=256)
- For tracheopexy, a posterior approach via semiprone position is preferred. — Em Gootee summarizes what Dr. Aaron Garrison said [Ep 5 · 4:23](https://origin-library.globalcastmd.com/watch/quad-2-thoracoscopic-tracheopexy-with-dr-aaron-garrison-7919?t=263)
- Creating a pneumothorax by putting the Veress off the tip of the scapula helps collapse the lung for trocar placement. — Em Gootee summarizes what Dr. Aaron Garrison said [Ep 5 · 4:28](https://origin-library.globalcastmd.com/watch/quad-2-thoracoscopic-tracheopexy-with-dr-aaron-garrison-7919?t=268)
- When operating posteriorly, triangulating your hands gives the best visualization and working space. — Em Gootee summarizes what Dr. Aaron Garrison said [Ep 5 · 4:38](https://origin-library.globalcastmd.com/watch/quad-2-thoracoscopic-tracheopexy-with-dr-aaron-garrison-7919?t=278)
- When available, a multidisciplinary team which includes a pulmonologist can allow for internal visualization via bronchoscopy. — Em Gootee summarizes what Dr. Aaron Garrison said [Ep 5 · 4:56](https://origin-library.globalcastmd.com/watch/quad-2-thoracoscopic-tracheopexy-with-dr-aaron-garrison-7919?t=296)
- Bronchoscopic guidance technique is primarily used in non-esophageal atresia patients. — Em Gootee summarizes what Dr. Aaron Garrison said [Ep 5 · 5:05](https://origin-library.globalcastmd.com/watch/quad-2-thoracoscopic-tracheopexy-with-dr-aaron-garrison-7919?t=305)
- It is important to create enough tension in the suture to ensure that the pexy is secure. — Em Gootee summarizes what Dr. Aaron Garrison said [Ep 5 · 5:53](https://origin-library.globalcastmd.com/watch/quad-2-thoracoscopic-tracheopexy-with-dr-aaron-garrison-7919?t=353)
- The approach changes for patients without esophageal atresia or with an esophagus in continuity. — Em Gootee summarizes what Dr. Aaron Garrison said [Ep 5 · 6:07](https://origin-library.globalcastmd.com/watch/quad-2-thoracoscopic-tracheopexy-with-dr-aaron-garrison-7919?t=367)
- For patients with esophagus in continuity, the first step is to dissect around the esophagus using a vessel loop for retraction. — Em Gootee summarizes what Dr. Aaron Garrison said [Ep 5 · 6:14](https://origin-library.globalcastmd.com/watch/quad-2-thoracoscopic-tracheopexy-with-dr-aaron-garrison-7919?t=374)
- Using pre- and post-operative bronchoscopy allows the surgeon to see the improvement prior to case completion. — Em Gootee summarizes what Dr. Aaron Garrison said [Ep 5 · 6:32](https://origin-library.globalcastmd.com/watch/quad-2-thoracoscopic-tracheopexy-with-dr-aaron-garrison-7919?t=392)
- Van Haal et al. conducted a retrospective cohort study in the Netherlands that included 79 patients who had rigid tracheobronchoscopy done before and after esophageal atresia surgery. — Lizzie Lee summarizes what Dr. Alex Halpern said [Ep 12 · 1:04](https://origin-library.globalcastmd.com/watch/quick-literature-updates-ep-27-11580?t=64)
- Preoperative tracheobronchoscopy for the presence of post-operative tracheomalacia had a sensitivity of 50% and a specificity of 67%. — Lizzie Lee summarizes what Dr. Alex Halpern said [Ep 12 · 1:24](https://origin-library.globalcastmd.com/watch/quick-literature-updates-ep-27-11580?t=84)
- Preoperative tracheobronchoscopy, though routine, has limited predictive value for post-operative tracheomalacia in esophageal atresia patients. — Lizzie Lee summarizes what Dr. Alex Halpern said [Ep 12 · 1:34](https://origin-library.globalcastmd.com/watch/quick-literature-updates-ep-27-11580?t=94)
- Mina et al. performed a retrospective review of all patients who underwent conservative management of modified Bell stage 2A or greater necrotizing enterocolitis at a single institution from 2011 to 2022. — Alex Halpern summarizing a resource [Ep 12 · 2:05](https://origin-library.globalcastmd.com/watch/quick-literature-updates-ep-27-11580?t=125)
- 126 patients underwent conservative management of necrotizing enterocolitis, and 24 of those patients eventually underwent surgery for a post-NEC stricture. — Alex Halpern summarizing a resource [Ep 12 · 2:20](https://origin-library.globalcastmd.com/watch/quick-literature-updates-ep-27-11580?t=140)
- Primary resection and anastomosis was performed in all cases of post-NEC stricture requiring surgery. — Alex Halpern summarizing a resource [Ep 12 · 2:29](https://origin-library.globalcastmd.com/watch/quick-literature-updates-ep-27-11580?t=149)
- Post-NEC strictures are a common occurrence after conservative management of necrotizing enterocolitis. — Alex Halpern summarizing a resource [Ep 12 · 2:33](https://origin-library.globalcastmd.com/watch/quick-literature-updates-ep-27-11580?t=153)
- Huncheid et al. conducted a multi-center non-inferiority trial that compared preterm infants treated with expectant management versus early ibuprofen for patent ductus arteriosus. — Cecilia Gigena summarizes what Dr. Alex Halpern said [Ep 12 · 3:04](https://origin-library.globalcastmd.com/watch/quick-literature-updates-ep-27-11580?t=184)
- The trial included 273 infants: 136 treated with expectant management and 137 with early ibuprofen. — Cecilia Gigena summarizes what Dr. Alex Halpern said [Ep 12 · 3:14](https://origin-library.globalcastmd.com/watch/quick-literature-updates-ep-27-11580?t=194)
- In the expectant management group for PDA, there was 17.6% necrotizing enterocolitis, 33% bronchopulmonary dysplasia, and 14% death rates. — Cecilia Gigena summarizes what Dr. Alex Halpern said [Ep 12 · 3:24](https://origin-library.globalcastmd.com/watch/quick-literature-updates-ep-27-11580?t=204)
- In the ibuprofen group for PDA, there was 15.4% necrotizing enterocolitis, 50% bronchopulmonary dysplasia, and 80% death rates. — Cecilia Gigena summarizes what Dr. Alex Halpern said [Ep 12 · 3:36](https://origin-library.globalcastmd.com/watch/quick-literature-updates-ep-27-11580?t=216)
- Expectant management is not inferior to early ibuprofen in preterm patients with patent ductus arteriosus. — Cecilia Gigena summarizes what Dr. Alex Halpern said [Ep 12 · 3:53](https://origin-library.globalcastmd.com/watch/quick-literature-updates-ep-27-11580?t=233)
- The paper examined 98 patients who had severe tracheomalacia with posterior membranous intrusion. — Ian Glenn summarizing a resource [Ep 1 · 0:28](https://origin-library.globalcastmd.com/watch/posterior-tracheopexy-for-severe-tracheomalacia-375?t=28)
- All patients received bronchoscopy showing the trachea tended to collapse inward from the posterior aspect. — Ian Glenn summarizing a resource [Ep 1 · 0:35](https://origin-library.globalcastmd.com/watch/posterior-tracheopexy-for-severe-tracheomalacia-375?t=35)
- The study distinguished between anterior compression (from the aortic arch) and posterior compression (collapse). — Ian Glenn summarizing a resource [Ep 1 · 0:44](https://origin-library.globalcastmd.com/watch/posterior-tracheopexy-for-severe-tracheomalacia-375?t=44)
- Posterior tracheopexy involves taking pledgeted sutures and sewing the posterior wall of the trachea to the anterior longitudinal ligament of the spine. — Ian Glenn summarizing a resource [Ep 1 · 0:54](https://origin-library.globalcastmd.com/watch/posterior-tracheopexy-for-severe-tracheomalacia-375?t=54)
- 88% of the 98 patients had esophageal atresia with or without TEF. — Ian Glenn summarizing a resource [Ep 1 · 1:05](https://origin-library.globalcastmd.com/watch/posterior-tracheopexy-for-severe-tracheomalacia-375?t=65)
- Patients were followed anywhere from 1 week to 36 months. — Ian Glenn summarizing a resource [Ep 1 · 1:05](https://origin-library.globalcastmd.com/watch/posterior-tracheopexy-for-severe-tracheomalacia-375?t=65)
- Clinical symptoms improved pretty much across the board, including cough, barking cough, noisy breathing, and infections. — Ian Glenn summarizing a resource [Ep 1 · 1:15](https://origin-library.globalcastmd.com/watch/posterior-tracheopexy-for-severe-tracheomalacia-375?t=75)
- Patients improved on bronchoscopic evaluation. — Ian Glenn summarizing a resource [Ep 1 · 1:25](https://origin-library.globalcastmd.com/watch/posterior-tracheopexy-for-severe-tracheomalacia-375?t=85)
- Exercise tolerance did not improve statistically but showed a trend towards improvement. — Ian Glenn summarizing a resource [Ep 1 · 1:30](https://origin-library.globalcastmd.com/watch/posterior-tracheopexy-for-severe-tracheomalacia-375?t=90)
- Tracheomalacia is not one homogeneous disease. — Ian Glenn summarizing a resource [Ep 1 · 1:35](https://origin-library.globalcastmd.com/watch/posterior-tracheopexy-for-severe-tracheomalacia-375?t=95)
- The paper emphasized the importance of systematic bronchoscopic evaluation. — Ian Glenn summarizing a resource [Ep 1 · 1:41](https://origin-library.globalcastmd.com/watch/posterior-tracheopexy-for-severe-tracheomalacia-375?t=101)
- Some patients benefit from posterior tracheopexy, some from aortopexy or anterior approach, and some need both. — Ian Glenn summarizing a resource [Ep 1 · 1:45](https://origin-library.globalcastmd.com/watch/posterior-tracheopexy-for-severe-tracheomalacia-375?t=105)
- Almost 20% of patients in the study required both posterior tracheopexy and aortopexy. — Ian Glenn summarizing a resource [Ep 1 · 1:54](https://origin-library.globalcastmd.com/watch/posterior-tracheopexy-for-severe-tracheomalacia-375?t=114)
- APSA created a peer support program for pediatric surgeons in 2020. — Lizzie Lee summarizes what Dr. Carlos Colunga said [Ep 10 · 1:00](https://origin-library.globalcastmd.com/watch/quick-literature-updates-ep-19-10465?t=60)
- The goal of the APSA peer support program was to support surgeons after traumatic events. — Lizzie Lee summarizes what Dr. Carlos Colunga said [Ep 10 · 1:12](https://origin-library.globalcastmd.com/watch/quick-literature-updates-ep-19-10465?t=72)
- The most common referral reasons for the peer support program were toxic work environments and adverse events. — Lizzie Lee summarizes what Dr. Carlos Colunga said [Ep 10 · 1:16](https://origin-library.globalcastmd.com/watch/quick-literature-updates-ep-19-10465?t=76)
- 50 surgeons total agreed to receive training on how to be a supporter in the APSA program. — Lizzie Lee summarizes what Dr. Carlos Colunga said [Ep 10 · 1:20](https://origin-library.globalcastmd.com/watch/quick-literature-updates-ep-19-10465?t=80)
- Over 80% of trained peer supporters were able to use these peer support skills informally with colleagues, partners, and trainees. — Lizzie Lee summarizes what Dr. Carlos Colunga said [Ep 10 · 1:25](https://origin-library.globalcastmd.com/watch/quick-literature-updates-ep-19-10465?t=85)
- The peer support program shows that this type of support system can work really well to help surgeons heal from traumatic experiences and toxic work environments. — Lizzie Lee summarizes what Dr. Carlos Colunga said [Ep 10 · 1:31](https://origin-library.globalcastmd.com/watch/quick-literature-updates-ep-19-10465?t=91)
- Tracheomalacia was 5% more common in tracheal occluded infants with CDH, with 4% more cases. — Carlos Colunga summarizing a resource [Ep 10 · 2:25](https://origin-library.globalcastmd.com/watch/quick-literature-updates-ep-19-10465?t=145)
- Tracheomalacia symptoms in FETO-treated CDH infants typically receded within 55 months. — Carlos Colunga summarizing a resource [Ep 10 · 2:25](https://origin-library.globalcastmd.com/watch/quick-literature-updates-ep-19-10465?t=145)
- FETO-treated CDH infants typically showed a larger trachea, which was around 31% wider. — Carlos Colunga summarizing a resource [Ep 10 · 2:34](https://origin-library.globalcastmd.com/watch/quick-literature-updates-ep-19-10465?t=154)
- 37% of tracheal occluded CDH cases retained metallic balloon components, although no significant complications were reported. — Carlos Colunga summarizing a resource [Ep 10 · 2:34](https://origin-library.globalcastmd.com/watch/quick-literature-updates-ep-19-10465?t=154)
- While tracheal occlusion is effective in promoting lung growth, it is associated with a higher risk of tracheomalacia, although most cases resolve and do not appear to have long-term effects. — Carlos Colunga summarizing a resource [Ep 10 · 2:47](https://origin-library.globalcastmd.com/watch/quick-literature-updates-ep-19-10465?t=167)
- The IPSO systematic review and meta-analysis gathered 8 retrospective studies with 490 patients comparing image-guided core needle biopsy to surgical biopsy for neuroblastoma. — Cecilia Gigena summarizes what Dr. Carlos Colunga said [Ep 10 · 3:27](https://origin-library.globalcastmd.com/watch/quick-literature-updates-ep-19-10465?t=207)
- Tissue adequacy and biological characterization of the biopsy was not significantly different between image-guided core needle biopsy and surgical biopsy groups for neuroblastoma. — Cecilia Gigena summarizes what Dr. Carlos Colunga said [Ep 10 · 3:40](https://origin-library.globalcastmd.com/watch/quick-literature-updates-ep-19-10465?t=220)
- Intraoperative transfusions and complications were higher in the surgical biopsy group compared to image-guided core needle biopsy for neuroblastoma. — Cecilia Gigena summarizes what Dr. Carlos Colunga said [Ep 10 · 3:54](https://origin-library.globalcastmd.com/watch/quick-literature-updates-ep-19-10465?t=234)
- Image-guided core needle biopsy is safe and effective for diagnosing neuroblastoma. — Cecilia Gigena summarizes what Dr. Carlos Colunga said [Ep 10 · 4:00](https://origin-library.globalcastmd.com/watch/quick-literature-updates-ep-19-10465?t=240)
- In a 2012 survey of IPEG surgeons by Dr. St. Peter, 60% of approximately 170 surgeons over 30 countries responded that they would routinely do preoperative bronchoscopy for EA repair. — Matt Dellinger summarizing a resource [Ep 11 · 2:27](https://origin-library.globalcastmd.com/watch/2025-pediatric-surgery-update-course-updates-in-esophageal-atresia-management-10895?t=147)
- An Italian group found that preoperative bronchoscopy was useful in 45% of EA patients, including for identifying proximal fistula in type A or type C, fistula occlusion concerns, and alteration of operative approach. — Matt Dellinger summarizing a resource [Ep 11 · 2:45](https://origin-library.globalcastmd.com/watch/2025-pediatric-surgery-update-course-updates-in-esophageal-atresia-management-10895?t=165)
- Primary tracheopexy at the time of EA repair in children with moderate to severe tracheomalacia (75% or greater collapse) has been associated with fewer life-threatening events, fewer hospitalizations for respiratory illnesses, and improved weight-for-age scores at 12 months, according to studies from Boston, Johns Hopkins, All Children's, and a group in the Netherlands. — Matt Dellinger summarizing a resource [Ep 11 · 10:00](https://origin-library.globalcastmd.com/watch/2025-pediatric-surgery-update-course-updates-in-esophageal-atresia-management-10895?t=600)
- Data from Austin shows that intraoperative recurrent laryngeal nerve monitoring appears to decrease nerve injury rates in high-risk cases, defined as esophageal atresia, cardiac surgery, or a combination thereof. — Matt Dellinger summarizing a resource [Ep 11 · 15:15](https://origin-library.globalcastmd.com/watch/2025-pediatric-surgery-update-course-updates-in-esophageal-atresia-management-10895?t=915)
- Laryngeal clefts come in different forms, and major clefts may require careful consideration before proceeding with general anesthesia as patients can decompensate if intubated. — Matt Dellinger summarizing a resource [Ep 11 · 4:45](https://origin-library.globalcastmd.com/watch/2025-pediatric-surgery-update-course-updates-in-esophageal-atresia-management-10895?t=285)
- Posterior tracheopexy was originally described in cases of recurrent tracheoesophageal fistula to separate suture lines and prevent second recurrence. — Matt Dellinger summarizing a resource [Ep 11 · 11:00](https://origin-library.globalcastmd.com/watch/2025-pediatric-surgery-update-course-updates-in-esophageal-atresia-management-10895?t=660)
- Tracheomalacia is weakening of the airway wall, which collapses the airway in lumen during respiration. — The host summarizing a resource [Ep 9 · 1:00](https://origin-library.globalcastmd.com/watch/quad-26-use-of-ultrashort-echo-time-mri-to-measure-tracheomalacia-in-neonates-wi-9953?t=60)
- The gold standard to diagnose tracheomalacia is bronchoscopy. — The host summarizing a resource [Ep 9 · 1:10](https://origin-library.globalcastmd.com/watch/quad-26-use-of-ultrashort-echo-time-mri-to-measure-tracheomalacia-in-neonates-wi-9953?t=70)
- Flexible bronchoscopy has variations in sedation and breathing vigor which can affect the static imaging. — The host summarizing a resource [Ep 9 · 1:15](https://origin-library.globalcastmd.com/watch/quad-26-use-of-ultrashort-echo-time-mri-to-measure-tracheomalacia-in-neonates-wi-9953?t=75)
- Ultra short echo time MRI uses motion tracking to evaluate tracheomalacia and is less invasive and doesn't use ionizing radiation. — The host summarizing a resource [Ep 9 · 1:25](https://origin-library.globalcastmd.com/watch/quad-26-use-of-ultrashort-echo-time-mri-to-measure-tracheomalacia-in-neonates-wi-9953?t=85)
- UTE MRI can be done in neonates without any sedation. — The host summarizing a resource [Ep 9 · 1:35](https://origin-library.globalcastmd.com/watch/quad-26-use-of-ultrashort-echo-time-mri-to-measure-tracheomalacia-in-neonates-wi-9953?t=95)
- Faulty division of the foregut suggests changes in the posterior membrane of the trachea that may make it more susceptible to being malacic. — The host summarizing a resource [Ep 9 · 1:55](https://origin-library.globalcastmd.com/watch/quad-26-use-of-ultrashort-echo-time-mri-to-measure-tracheomalacia-in-neonates-wi-9953?t=115)
- Long gap esophageal atresia patients have more tracheomalacia than short gap esophageal atresia patients. — The host summarizing a resource [Ep 9 · 2:20](https://origin-library.globalcastmd.com/watch/quad-26-use-of-ultrashort-echo-time-mri-to-measure-tracheomalacia-in-neonates-wi-9953?t=140)
- The trachea was divided into thirds to look at what was going on in different parts of the airway. — The host summarizing a resource [Ep 9 · 2:28](https://origin-library.globalcastmd.com/watch/quad-26-use-of-ultrashort-echo-time-mri-to-measure-tracheomalacia-in-neonates-wi-9953?t=148)
- Tracheal eccentricity refers to how off-center the trachea's position is from where it should be, with smaller values representing a more eccentric airway. — The host summarizing a resource [Ep 9 · 2:35](https://origin-library.globalcastmd.com/watch/quad-26-use-of-ultrashort-echo-time-mri-to-measure-tracheomalacia-in-neonates-wi-9953?t=155)
- The period of expiration is when you see the most collapse during tracheomalacia. — The host summarizing a resource [Ep 9 · 2:48](https://origin-library.globalcastmd.com/watch/quad-26-use-of-ultrashort-echo-time-mri-to-measure-tracheomalacia-in-neonates-wi-9953?t=168)
- The minimum value during the period of expiration was used in each third of the trachea for measurement. — The host summarizing a resource [Ep 9 · 2:55](https://origin-library.globalcastmd.com/watch/quad-26-use-of-ultrashort-echo-time-mri-to-measure-tracheomalacia-in-neonates-wi-9953?t=175)
- The retrospective study included 26 patients with esophageal atresia who had preoperative studies prior to their TEF/EA repair. — The host summarizing a resource [Ep 9 · 3:02](https://origin-library.globalcastmd.com/watch/quad-26-use-of-ultrashort-echo-time-mri-to-measure-tracheomalacia-in-neonates-wi-9953?t=182)
- A subset of patients had post-op imaging after their repair and ligation. — The host summarizing a resource [Ep 9 · 3:12](https://origin-library.globalcastmd.com/watch/quad-26-use-of-ultrashort-echo-time-mri-to-measure-tracheomalacia-in-neonates-wi-9953?t=192)
- Short gap was defined as two centimeters or less between the proximal and distal pouch. — The host summarizing a resource [Ep 9 · 3:20](https://origin-library.globalcastmd.com/watch/quad-26-use-of-ultrashort-echo-time-mri-to-measure-tracheomalacia-in-neonates-wi-9953?t=200)
- Most of the patients had a distal tracheoesophageal fistula. — The host summarizing a resource [Ep 9 · 3:30](https://origin-library.globalcastmd.com/watch/quad-26-use-of-ultrashort-echo-time-mri-to-measure-tracheomalacia-in-neonates-wi-9953?t=210)
- The majority of the patients had a short gap esophageal atresia. — The host summarizing a resource [Ep 9 · 3:35](https://origin-library.globalcastmd.com/watch/quad-26-use-of-ultrashort-echo-time-mri-to-measure-tracheomalacia-in-neonates-wi-9953?t=215)
- A portion of these patients required at least one steroid or one pneumonia course per year afterwards. — The host summarizing a resource [Ep 9 · 3:40](https://origin-library.globalcastmd.com/watch/quad-26-use-of-ultrashort-echo-time-mri-to-measure-tracheomalacia-in-neonates-wi-9953?t=220)
- Along all levels of the trachea, the long gap esophageal atresia patients had a more eccentric trachea compared to short gap patients. — The host summarizing a resource [Ep 9 · 3:48](https://origin-library.globalcastmd.com/watch/quad-26-use-of-ultrashort-echo-time-mri-to-measure-tracheomalacia-in-neonates-wi-9953?t=228)
- When looking at bronchoscopy results, there wasn't a lot of difference in terms of the patients that had significant collapse greater than 75%. — The host summarizing a resource [Ep 9 · 3:58](https://origin-library.globalcastmd.com/watch/quad-26-use-of-ultrashort-echo-time-mri-to-measure-tracheomalacia-in-neonates-wi-9953?t=238)
- In the upper third of the trachea, the eccentricity was significantly improved after the repair. — The host summarizing a resource [Ep 9 · 4:12](https://origin-library.globalcastmd.com/watch/quad-26-use-of-ultrashort-echo-time-mri-to-measure-tracheomalacia-in-neonates-wi-9953?t=252)
- In the distal trachea, the eccentricity got significantly worse after repair. — The host summarizing a resource [Ep 9 · 4:20](https://origin-library.globalcastmd.com/watch/quad-26-use-of-ultrashort-echo-time-mri-to-measure-tracheomalacia-in-neonates-wi-9953?t=260)
- The middle portion of the trachea remained unchanged after repair. — The host summarizing a resource [Ep 9 · 4:27](https://origin-library.globalcastmd.com/watch/quad-26-use-of-ultrashort-echo-time-mri-to-measure-tracheomalacia-in-neonates-wi-9953?t=267)
- Upper trachea improvement is probably because there is a dilated esophageal pouch, and once you decompress that, it also relieves the compression on the upper trachea. — The host summarizing a resource [Ep 9 · 4:32](https://origin-library.globalcastmd.com/watch/quad-26-use-of-ultrashort-echo-time-mri-to-measure-tracheomalacia-in-neonates-wi-9953?t=272)
- Changes in the lower trachea are suspected to be due to mobilization of the distal segment and ligation of the TEF. — The host summarizing a resource [Ep 9 · 4:43](https://origin-library.globalcastmd.com/watch/quad-26-use-of-ultrashort-echo-time-mri-to-measure-tracheomalacia-in-neonates-wi-9953?t=283)
- Despite having a significantly longer NICU stay, long gap esophageal atresia patients were more likely to have respiratory-related admissions. — The host summarizing a resource [Ep 9 · 4:55](https://origin-library.globalcastmd.com/watch/quad-26-use-of-ultrashort-echo-time-mri-to-measure-tracheomalacia-in-neonates-wi-9953?t=295)
- Long gap esophageal atresia patients have a higher risk of significant tracheomalacia. — The host summarizing a resource [Ep 9 · 5:05](https://origin-library.globalcastmd.com/watch/quad-26-use-of-ultrashort-echo-time-mri-to-measure-tracheomalacia-in-neonates-wi-9953?t=305)
- Long gap EA patients had a more eccentric or flattened airway along the length of the airway. — The host summarizing a resource [Ep 9 · 5:12](https://origin-library.globalcastmd.com/watch/quad-26-use-of-ultrashort-echo-time-mri-to-measure-tracheomalacia-in-neonates-wi-9953?t=312)
- After repair, the eccentricity worsened in the distal third of the trachea. — The host summarizing a resource [Ep 9 · 5:20](https://origin-library.globalcastmd.com/watch/quad-26-use-of-ultrashort-echo-time-mri-to-measure-tracheomalacia-in-neonates-wi-9953?t=320)
- The distal third is an important segment to consider, even if it doesn't look severe when you do your first bronchoscopy. — The host summarizing a resource [Ep 9 · 5:26](https://origin-library.globalcastmd.com/watch/quad-26-use-of-ultrashort-echo-time-mri-to-measure-tracheomalacia-in-neonates-wi-9953?t=326)
- Ultra-short echo-time MRI effectively evaluates the severity of tracheomalacia without intubation, sedation, or radiation in neonates. — The host summarizing a resource [Ep 9 · 5:38](https://origin-library.globalcastmd.com/watch/quad-26-use-of-ultrashort-echo-time-mri-to-measure-tracheomalacia-in-neonates-wi-9953?t=338)
- Innominate artery compression was initially described in the 1940s by Gross et al. — Brittany Levy summarizing a resource [Ep 6 · 1:00](https://origin-library.globalcastmd.com/watch/quad-17-innominate-artery-compression-and-management-through-the-neck-dr-doug-vo-9204?t=60)
- Innominate artery compression occurs in about 30% of children under 2 years old — Brittany Levy summarizing a resource [Ep 6 · 1:15](https://origin-library.globalcastmd.com/watch/quad-17-innominate-artery-compression-and-management-through-the-neck-dr-doug-vo-9204?t=75)
- Partial innominate artery compression can be seen commonly on routine bronchoscopies — Brittany Levy summarizing a resource [Ep 6 · 1:25](https://origin-library.globalcastmd.com/watch/quad-17-innominate-artery-compression-and-management-through-the-neck-dr-doug-vo-9204?t=85)
- Many patients with innominate artery compression are asymptomatic and do not need intervention — Brittany Levy summarizing a resource [Ep 6 · 1:35](https://origin-library.globalcastmd.com/watch/quad-17-innominate-artery-compression-and-management-through-the-neck-dr-doug-vo-9204?t=95)
- Intervention should be considered when innominate artery compression is associated with tracheomalacia or obstructive symptoms — Brittany Levy summarizing a resource [Ep 6 · 1:45](https://origin-library.globalcastmd.com/watch/quad-17-innominate-artery-compression-and-management-through-the-neck-dr-doug-vo-9204?t=105)
- Morbido et al. described a cervical approach to the innominate artery using a partial sternotomy — Brittany Levy summarizing a resource [Ep 6 · 2:00](https://origin-library.globalcastmd.com/watch/quad-17-innominate-artery-compression-and-management-through-the-neck-dr-doug-vo-9204?t=120)
- Yardley's group performed the procedure on 22 patients through a lower transverse cervical incision — Brittany Levy summarizing a resource [Ep 6 · 2:10](https://origin-library.globalcastmd.com/watch/quad-17-innominate-artery-compression-and-management-through-the-neck-dr-doug-vo-9204?t=130)
- Yardley's group achieved improvement in tracheal lumen of 35 to 80% in their series — Brittany Levy summarizing a resource [Ep 6 · 2:20](https://origin-library.globalcastmd.com/watch/quad-17-innominate-artery-compression-and-management-through-the-neck-dr-doug-vo-9204?t=140)
- Yardley's group saw improvement in symptoms in 72% of their patients — Brittany Levy summarizing a resource [Ep 6 · 2:28](https://origin-library.globalcastmd.com/watch/quad-17-innominate-artery-compression-and-management-through-the-neck-dr-doug-vo-9204?t=148)
- Syndromic patients had inferior outcomes with the cervical approach in Yardley's series — Brittany Levy summarizing a resource [Ep 6 · 2:35](https://origin-library.globalcastmd.com/watch/quad-17-innominate-artery-compression-and-management-through-the-neck-dr-doug-vo-9204?t=155)
- The case patient was a six-month-old with long gap esophageal atresia who had undergone a prior repair attempt with proximal pouch perforation and issues with TEF ligation — Brittany Levy summarizing a resource [Ep 6 · 2:55](https://origin-library.globalcastmd.com/watch/quad-17-innominate-artery-compression-and-management-through-the-neck-dr-doug-vo-9204?t=175)
- The case patient had a right-sided esophagostomy, right vocal cord paralysis, and required CPAP of 8 — Brittany Levy summarizing a resource [Ep 6 · 3:15](https://origin-library.globalcastmd.com/watch/quad-17-innominate-artery-compression-and-management-through-the-neck-dr-doug-vo-9204?t=195)
- It is important to try not to dissect between the artery and the trachea during the procedure — Brittany Levy summarizing a resource [Ep 6 · 3:55](https://origin-library.globalcastmd.com/watch/quad-17-innominate-artery-compression-and-management-through-the-neck-dr-doug-vo-9204?t=235)
- The goal is to pull the artery forward and also drag the anterior tracheal wall forward — Brittany Levy summarizing a resource [Ep 6 · 4:05](https://origin-library.globalcastmd.com/watch/quad-17-innominate-artery-compression-and-management-through-the-neck-dr-doug-vo-9204?t=245)
- The cervical approach provides a good view of the anterior tracheal wall allowing placement of an anterior tracheopexy stitch if needed — Brittany Levy summarizing a resource [Ep 6 · 4:13](https://origin-library.globalcastmd.com/watch/quad-17-innominate-artery-compression-and-management-through-the-neck-dr-doug-vo-9204?t=253)
- Post-operative bronchoscopy showed improvement of the tracheal lumen in the case patient — Brittany Levy summarizing a resource [Ep 6 · 4:25](https://origin-library.globalcastmd.com/watch/quad-17-innominate-artery-compression-and-management-through-the-neck-dr-doug-vo-9204?t=265)
- The case patient was weaned off oxygen and discharged home on room air — Brittany Levy summarizing a resource [Ep 6 · 4:33](https://origin-library.globalcastmd.com/watch/quad-17-innominate-artery-compression-and-management-through-the-neck-dr-doug-vo-9204?t=273)
- At Cincinnati Children's Hospital, 2 out of 3 patients with tracheostomies were decannulated after the procedure — Brittany Levy summarizing a resource [Ep 6 · 4:40](https://origin-library.globalcastmd.com/watch/quad-17-innominate-artery-compression-and-management-through-the-neck-dr-doug-vo-9204?t=280)
- Some patients at Cincinnati Children's Hospital were discharged in 24 to 48 hours after the procedure — Brittany Levy summarizing a resource [Ep 6 · 4:50](https://origin-library.globalcastmd.com/watch/quad-17-innominate-artery-compression-and-management-through-the-neck-dr-doug-vo-9204?t=290)
- Patients with reduced room in the thoracic outlet may have inferior outcomes — Brittany Levy summarizing a resource [Ep 6 · 4:58](https://origin-library.globalcastmd.com/watch/quad-17-innominate-artery-compression-and-management-through-the-neck-dr-doug-vo-9204?t=298)
- Cincinnati Children's Hospital team found that patients with less than 1 centimeter of space between the innominate artery and the back of the sternum on CT had inferior results — Brittany Levy summarizing a resource [Ep 6 · 5:06](https://origin-library.globalcastmd.com/watch/quad-17-innominate-artery-compression-and-management-through-the-neck-dr-doug-vo-9204?t=306)
- Ideal candidates have the innominate artery positioned high and easy to access through the neck — Brittany Levy summarizing a resource [Ep 6 · 5:20](https://origin-library.globalcastmd.com/watch/quad-17-innominate-artery-compression-and-management-through-the-neck-dr-doug-vo-9204?t=320)
- The Dutch study evaluated close to 80 esophageal atresia patients comparing preoperative to postoperative bronchoscopy findings — Mikko Pakarinen summarizing the discussion [Ep 8 · 7:48](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-4th-quarter-2024-9760?t=468)
- Definite tracheomalacia was defined as almost complete or complete collapse of the airway on bronchoscopy — Anna Flirt van Gaal summarizing the discussion [Ep 8 · 8:37](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-4th-quarter-2024-9760?t=517)
- Suspected tracheomalacia was defined based on symptoms including barking cough and upper airway infections — Anna Flirt van Gaal summarizing the discussion [Ep 8 · 8:37](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-4th-quarter-2024-9760?t=517)
- The sensitivity and specificity of preoperative tracheal bronchoscopy for predicting tracheomalacia outcomes were around 50% — Anna Flirt van Gaal summarizing the discussion [Ep 8 · 8:37](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-4th-quarter-2024-9760?t=517)
- Many centers typically keep children in hospital for one to two days after elective laparoscopic gastrostomy tube placement to allow time for family education, feeding plan setup, and tolerance verification — Pablo Laje summarizing the discussion [Ep 8 · 11:35](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-4th-quarter-2024-9760?t=695)
- The study excluded patients who came to hospital from emergency room or were transferred from other facilities, as well as those who remained hospitalized more than 2 days — Pablo Laje summarizing the discussion [Ep 8 · 15:20](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-4th-quarter-2024-9760?t=920)
- Up to one-third of EA patients were historically believed to have tracheomalacia. — Basma Magdy summarizing a resource [Ep 3 · 0:00](https://origin-library.globalcastmd.com/watch/bob-ped-surg-2023-basma-magdy-papsa-presentation-6363?t=0)
- Recent reports suggest tracheomalacia could be encountered in up to 80% of EA patients. — Basma Magdy summarizing a resource [Ep 3 · 0:00](https://origin-library.globalcastmd.com/watch/bob-ped-surg-2023-basma-magdy-papsa-presentation-6363?t=0)
- Tracheomalacia is so prominent in patients with esophageal atresia that the Utrecht group performs posterior tracheopexy proactively during primary repair instead of requiring a second operation. — Todd Ponsky summarizes what Dr. Stephan Derhauf said [Ep 2 · 1:57](https://origin-library.globalcastmd.com/watch/posterior-tracheopexy-during-primary-esophageal-atresia-repair-501?t=117)

## Changelog
- Sep 24: 6 items added automatically
- Sep 23: 1 item no longer name tracheomalacia
- Sep 7: 2 items added automatically
- Sep 7: 5 items added automatically

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