Literature review: tracheomalacia diagnosis, NEC strictures, and PDA management

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.

Pre-operative tracheobronchoscopy for the presence of post-operative tracheomalacia had a sensitivity of 50% and a specificity of 67%.

Pre-operative tracheobronchoscopy, though routine, has limited predictive value for post-operative tracheomalacia in esophageal atresia patients.

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.

126 patients underwent conservative management of necrotizing enterocolitis, and 24 of those patients eventually underwent surgery for a post-NEC stricture.

Primary resection and anastomosis was performed in all cases of post-NEC stricture requiring surgery.

Post-NEC strictures are a common occurrence after conservative management of necrotizing enterocolitis.

Hunhide et al. conducted a multi-center non-inferiority trial that compared pre-term infants treated with expectant management versus early ibuprofen for patent ductus arteriosus.

The trial included 273 infants: 136 treated with expectant management and 137 with early ibuprofen.

In the expectant management group for PDA, there were 17.6% necrotizing enterocolitis, 33% bronchopulmonary dysplasia, and 14% death rates.

In the ibuprofen group for PDA, there were 15.4% necrotizing enterocolitis, 50% bronchopulmonary dysplasia, and 18% death rates.

Expectant management is non-inferior to early ibuprofen in preterm patients with patent ductus arteriosus.