Valencia, Spain | 16 - 18 May 2024 11th EORNA Congress ePosters 81 439 SUPRASTOMAL COLLAPSE OF TRACHEOSTOMIZED FIVE-YEAR OLD GIRL WITH DOWN SYNDROME Andriana Stefaniotou1 1, Maria Kapnisaki1, Evgeneia Tzavara1, Vasiliki Kokkinou1, Eirini Vazaiou1, Nektarios Papapetropoulos1 1Thivon 3, Athina, Greece Background: Suprastomal collapse is the collapse of the anterior tracheal wall in the inlet of the trachea above the stroma. This situation leads to airway obstruction during respiration. Objectives: The surgical options of treating the suprastomal collapse and the presentation of the way we treated our patient. Results: The patient is a five-year-old girl with down syndrome with the antecedent successful cardiovascular surgery at the age of 6 and 18 months. Two years later she was admitted to the intensive care unit for nearly two months due to pneumococcal respiratory infection for which she had underwent tracheostomy. Because of the severity of the infection, she had at the beginning twenty-four hours need of oxygenation. By the age of four years old she suffered of repeated respiratory infections with multiple hospitalizations, the latest with parainfluenza virus for which she needed High Flow Tracheal Oxygenation. Two months later she succeeded to remain without additional oxygen therapy and the stoma was always padded. The extubating process started with twenty-four hours oximetry, with the tube closed, which was normal. Shortly after she began to have hemorrhagic discharge from the stoma during the tracheal bathing. She underwent a bronchoscopy where she was diagnosed with suprastomal collapse. She was referred to our center for further treatment. We conducted a new bronchoscopy, and the prior findings were confirmed. With the use of cold instruments, we removed the excessive collapsed mucosa. The tracheostomy remained for another two days and after that the girl was decannulated. Conclusion: Bronchoscopy is used to diagnose suprastomal collapse. Treatment options, among others, include excision with cold instruments, endoscopic excision, tracheal resection, and anastomoses. 440 SURGERY FOR MALE STRESS URINARY INCONTINENCE. ATOMS DEVICE Carlos Retortillo García1, Francisco Javier Codobés Gibello1, Pilar Serrano Cabeza1, María del Carmen García Rodríguez1 1Hospital Universitario de Cáceres, Bloque Quirúrgico, Cáceres, Spain Background: Cancer is one of the leading causes of morbidity and mortality in the world. Prostate tumours are the fifth most common tumour in the world and the leading cause of death in men. Survival has increased in recent years due to the variety of available treatments depending on the stage of the cancer, with radical, open or laparoscopic surgery being possible. One of the complications after radical prostatectomy is stress urinary incontinence. One of the newest treatment options is the use of slings. One such system is the ATOMs (adjustable transobturator male system). Objectives: • To explain the surgical technique of placing the ATOMs system. • To report on the number of re-interventions due to extrusion of the system. Methods: Observational study carried out at the HUCC from 2020 to the present. A total of 14 patients underwent ATOMs surgery. Results: 14 patients underwent ATOMs surgery, 6 of which were reoperated due to extrusion of the system. Conclusion: • Safe and suitable device for post-prostatectomy male incontinent patients. • Good treatment for the correction and control of mild to medium post-surgical urinary incontinence. • Improvement in voiding frequency. • We do not have a significant number of cases to establish clear results of effectiveness. • Progress on the learning curve for professionals. • One of the limitations of the study is the lack of physical follow-up of the patients who underwent surgery.
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