Novosti
Khirurgii

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Year 2021 Vol. 29 No 1

PEDIATRIC SURGERY

A.N. VORONETSKY 1, A.E. DANOVICH 2

NEODYMIUM LASER IN LARINGOTRACHEOSTENOSIS TREATMENT AFTER TRACHEOSTOMY IN CHILDREN


Belarusian State Medical University 1,
The 6th City Clinical Hospital 2, Minsk,
The Republic of Belarus

Objective. To evaluate the effect of neodymium laser application for successful decannulation in infants with a congenital and acquired tracheal stenosis and tracheostomy.
Methods. 6 children were being treated in the 1st City Clinical Hospital of Minsk in 2011-2014. All children underwent tracheostomy with a prolonged tracheal intubation and subsequent development of tracheostenosis. The children were examined using X-ray, esophagogastroscopy (PentaxEG-16K10), and bronchoscopy (Olympus MAF TYPE GM). Tracheal stenosis was treated using a medical multifunctional laser complex Multiline (“Linline Medical systems” Ltd, Belarus) equipped with a high-energy neodymium laser emitter. Children with excessive growth of granulations in the lumen of the trachea underwent vaporization of granulations by means of a bulbous probe with a neodymium laser emitter (wavelength of 1340 nm, power: 15 W, 2 sec. exposure). In cicatricial tracheal stenosis, incisions were made with a laser scalpel (the wavelength of 1064 nm, power of 20 W).
Results. Effective decannulation was observed in 5 children, including 4 children who underwent 3-5 treatment sessions. In 1 child with the congenital subglottic larynx stenosis, to perform the decannulation became possible after 2 years and 24 sessions of laser recanalization of stenosis and ablation of granulations. One child, after 9 treatment sessions, dropped out of observation, the result has not been defined.
Conclusion. Tracheostomy in children promotes the formation of granulations in the tracheal lumen with the formation of stenosis, which subsequently hinders a successful decannulation. The neodymium laser application with the endoscopic access provides the visual direct approach to the focus of impact with the aim of laser-induced vaporization of soft tissues and recanalization of the tracheal mass in children with short tracheal stenosis leads to successful decannulation.

Keywords: Tracheostomy, tracheal stenosis, neodymium laser, endoscopy, infants
p. 38-45 of the original issue
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Address for correspondence:
220116, Republic of Belarus,
Minsk, Dzerzhinsky Av., 83,
Belarusian State Medical University,
the Pediatric Surgery Department,
tel. mob.: +375 029 32-902-32,
e-mail: anvoron@mail.ru,
Voronetsky Alexandr N.
Information about the authors:
Voronetsky Alexandr N., PhD, Associate Professor of the Pediatric Surgery Department, Belarusian State Medical University, Minsk, Republic of Belarus.
https://orcid.org/0000-0001-7091-376X
Danovich Alexandr E., Head of the Endoscopy Unit, the 6th City Clinical Hospital, Minsk, Republic of Belarus.
https://orcid.org/0000-0002-8149-2363
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