Source: Annual Congress 2009 - How to deal with tracheal stenosis

Abstract

Rationale: Little is known about the etiology of Tracheobronchomalacia (TBM) and exacerbating factors. Gastroesophageal reflux disease (GERD) has been associated with respiratory disorders and a higher prevalence of GERD has been noted in infants with TBM; such data is lacking in adults.
Objectives: To determine the prevalence of GERD in an adult TBM population and its impact on outcomes of tracheoplasty.
Methods: Prospective cohort study of 30 (12 male) adult TBM patients who underwent testing for GERD by pH probe, impedance, or upper endoscopy.
Results: 17 of 30 patients were GERD (+) yielding a prevalence of 56% in this unselected TBM population (prevalence in the western world 20%, p<0.001). The mean DeMeester score of GERD (+) patients was 40.7 (range 17-99.2), there was no reflux symptom correlation in 50% of patients. Twelve of the 30 patients underwent tracheoplasty for treatment. Seven of 12 were GERD (+); 3 of the 7 (42.8%) had an unsuccessful tracheoplasty; 2 of these 3 had DeMeester scores >50 and required fundoplication. Only 1 of 5 (20%) GERD (-) tracheoplasty patients had an unsuccessful repair.
Conclusion: GERD seems more prevalent in the TBM population compared with the general population. It may be silent and may negatively impact the outcome of surgical tracheoplasty.

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A. Ernst, D. Nataraj, A. Majid, M. DeCamp, R. Chuttani, A. Lembo, F. Herth, M. Kent, S. Gangadharan (Boston, United States Of America; Heidelberg, Germany). Prevalence of gastroesophageal reflux in patients with tracheobronchomalacia. Eur Respir J 2009; 34: Suppl. 53, 4241

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