Posterior tracheopexy in children with severe tracheomalacia: Insights from a Colombian multicenter study

D Romero¹, A Soler², C Villa³, M Cuellar³, M Perilla⁴, D Cleves⁵, L Suárez⁴, M Villamil², ME Gamma⁴, C Zuluaga⁶, A Castrillón², E Hernández⁷, JS Cabrera², J Páez², C Blanco⁴, A Echeverri³, P Ocampo⁷, ML Porras⁷, T Sarquis⁴, J Osorio⁴, H de la Barrera⁷, V Caicedo⁴

¹Hospital de la Misericordia, Clínica Shaio, Clínica Somer, Hospital San José Infantil
²Universidad Nacional de Colombia, Fundación Hospital pediátrico La Misericordia
³Clínica Somer
⁴Clínica Shaio
⁵Fundación Santa Fé
⁶Clínica Shaio, Hospital de la Misericordia
⁷Hospital San José Infantil

Purpose

Severe tracheomalacia causes dynamic airway collapse, leading to disabling respiratory symptoms and ventilatory dependence. This study presents the outcomes of posterior tracheopexy in pediatric patients across multiple centers, highlighting the procedure’s transformative impact on patient recovery and family life.

Methods

A retrospective study evaluated the experience of an airway surgery group led by a single surgeon who performed posterior tracheopexy across four centers in two cities in Colombia, from May 2018 to March 2025. Clinical history, associated malformations, surgical approaches, and postoperative outcomes were analyzed. All patients underwent posterior tracheopexy, with additional procedures performed based on bronchoscopy and intraoperative findings.

Results

Twenty-seven children were included in the study, with a median age at tracheomalacia diagnosis of 9 months. The most common associated malformation was esophageal atresia, followed by tracheal diverticulum. The most frequent preoperative symptom was a barking cough, present in 100% of patients, which improved in all cases postoperatively. Before surgery, 40% of the patients had experienced BRUE (brief resolved unexplained events); none recurred after the intervention. Patients who had between 1 and 22 respiratory infections per month showed complete resolution of these episodes postoperatively, resulting in a marked reduction in hospitalizations. Most no longer required inpatient care following surgery. Mortality was associated with complex comorbidities unrelated to the surgical technique itself.

Conclusion

Posterior tracheopexy provides more than anatomical correction—it offers a dramatic clinical turnaround for children with severe tracheomalacia. When performed early by a multidisciplinary team, this procedure can restore function, reduce complications, and significantly improve daily life for both patients and their families.

Keywords: Posterior tracheopexy, severe tracheomalacia, multicenter study, bronchoscopy

D Romero¹, A Soler², C Villa³, M Cuellar³, M Perilla⁴, D Cleves⁵, L Suárez⁴, M Villamil², ME Gamma⁴, C Zuluaga⁶, A Castrillón², E Hernández⁷, JS Cabrera², J Páez², C Blanco⁴, A Echeverri³, P Ocampo⁷, ML Porras⁷, T Sarquis⁴, J Osorio⁴, H de la Barrera⁷, V Caicedo⁴

¹Hospital de la Misericordia, Clínica Shaio, Clínica Somer, Hospital San José Infantil
²Universidad Nacional de Colombia, Fundación Hospital pediátrico La Misericordia
³Clínica Somer
⁴Clínica Shaio
⁵Fundación Santa Fé
⁶Clínica Shaio, Hospital de la Misericordia
⁷Hospital San José Infantil

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