Primary posterior tracheopexy in esophageal atresia with tracheomalacia: From innovation to multicenter RCT

jpedsurg.org

Tracheomalacia (TM) is a common comorbidity in children with esophageal atresia (EA), reported in up to 87 % of patients. Around 30 % of EA patients develop severe TM associated with recurrent respiratory morbidity. In such cases, surgical intervention may be required. Traditionally, treatment involved secondary procedures such as aortopexy or posterior tracheopexy. More recently, primary posterior tracheopexy (PPT) has been adopted in an increasing number of centers.The evolution of the surgical treatment of TM from secondary to primary intervention is described.

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Article · Aug 2025 · 1 min read

In brief

This article traces the surgical evolution from secondary to primary posterior tracheopexy for treating severe tracheomalacia in esophageal atresia patients. It discusses how up to 30% of EA patients develop severe TM requiring intervention, and examines the shift toward performing tracheopexy during initial EA repair rather than as a delayed procedure.

Tracheomalacia affects up to 87% of esophageal atresia patients, with 30% developing severe disease requiring intervention.
Primary posterior tracheopexy is increasingly replacing secondary procedures like aortopexy for severe tracheomalacia in EA patients.
Surgical management of EA-associated tracheomalacia has evolved from reactive secondary treatment to proactive primary intervention.

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