Clinical Outcomes After Tracheobronchoplasty With Ringed Polytetrafluoroethylene Vascular Graft.

Abstract

<h4>Background</h4>This report describes the surgical technique and outcomes of tracheobronchoplasty (TBP) with ringed polytetrafluoroethylene (PTFE) vascular graft.<h4>Methods</h4>We identified all patients who underwent PTFE-TBP for severe expiratory central airway collapse from January 1, 2018 to August 2021 at Mayo Clinic, Florida. Preoperative and postoperative St George's Respiratory Questionnaire (SGRQ), Cough-Specific Quality of Life Questionnaire (CSQLQ), pulmonary function testing, 6-minute walk test, and blinded dynamic bronchoscopy videos at 3-month follow-up were used to assess outcomes.<h4>Results</h4>Fourteen patients (median age, 62.5 years; 64.3% female) underwent PTFE-TBP. The median operative time was 355 minutes, median hospital length of stay was 5 days, and median intensive care unit stay was 1 day. One patient had a Clavien-Dindo grade ≥3 complication. Comparison of preoperative and postoperative questionnaire scores demonstrated improvement in median SGRQ score by 14.79 (<i>P</i> = .013) and CSQLQ score by 22 (<i>P</i> = .005). Preoperative and postoperative pulmonary function and 6-minute walk test results showed no significant difference. Postoperative bronchoscopy demonstrated improvement in median collapsibility of mid trachea by 39.6% (<i>P</i> < .001), distal trachea by 50% (<i>P</i> < .001), left main bronchus by 38.2% (<i>P</i> < .001), right main bronchus by 37.9% (<i>P</i> < .001), and bronchus intermedius by 30.7% (<i>P</i> < .001).<h4>Conclusions</h4>PTFE-TBP provides significant improvement in patients' symptoms and expiratory central airway collapse as judged by preoperative and postoperative quality of life questionnaires and bronchoscopy.