Introduction: The current literature lacks a comprehensive investigation into the use of flexible bronchoscopy (FB) in the treatment of childhood atelectasis. Methods: In this retrospective study, the data of pediatric patients who were diagnosed with atelectasis and underwent FB for diagnostic and therapeutic purposes in our center from January 1, 2017 to December 31, 2022 were retracted from medical records. The study aimed to assess the effectiveness of FB in diagnosing and treating atelectasis in children, identifying the appropriate patient population and the optimal timing for intervention. Results: A total of 108 children, with a median age of 4.9 years (14 days-18 years), underwent FB. At the time atelectasis was detected, at least one underlying disease was present in 62% of the patients. Based on the macroscopic and microscopic FB findings, 86.1% of the patients received a new diagnosis, and 83.3% of the patients were prescribed additional new treatments. At the last outpatient visit, complete resolution of the atelectasis was observed in 40.8% of patients, while 31.4% showed no resolution. The duration from the diagnosis of atelectasis to FB was shorter in patients with partial or complete resolution. Patients without additional radiological abnormalities or scoliosis had higher resolution rates, while those with congenital cardiac diseases, immunodeficiency, or primary ciliary dyskinesia had lower rates. Conclusion: Children with atelectasis who do not respond to conventional treatments within three weeks may undergo FB. Delayed FB contributes to failure in resolving atelectasis, prolonged recovery times, and increased recurrence rates, particularly in patients with underlying diseases.

INTRODUCTION: Recurrent pulmonary infections, wheezing and stridor due to swallowing dysfunction, esophageal dysmotility, gastroesophageal reflux, tracheomalacia and bronchomalacia are frequently seen complications after esophageal atresia and tracheo-oesophageal fistula (EA-TEF) surgeries. This study aimed to investigate the frequency and causes of respiratory problems and to evaluate the factors that affect respiratory morbidity in patients who had undergone EA-TEF repair in a tertiary referral center. METHODS: Preoperative and postoperative records of patients with EA, TEF+EA and isolated EA were examined retrospectively. Accompanied diseases and swallowing dysfunction symptoms were questioned. Bronchoalveolar lavage results were investigated if the patient had flexible bronchoscopy. RESULTS: A total of 71 children with EA were included in the study, and seven patients who did not have follow-up after surgery were excluded. 46 of the 64 patients continue regular follow-up visits in our department. Male sex, primary EA repair in another center, EA type C, accompanying genetic anomalies, severe tracheomalacia, late per oral feeding (1 year after surgery), and severe GER were found to cause significantly higher incidence of coughing, recurrent wheezing, recurrent pneumonia, and bronchiectasis despite surgical and medical treatments (p = 0.048, p = 0.045, p = 0.009, p = 0.029, p = 0.025) CONCLUSİON: Even if anatomical anomalies are corrected by surgery in patients who underwent EA repair, precautions can be taken for GERD, laryngotracheomalacia, and swallowing dysfunction, and effective pulmonary rehabilitation can be initiated with early multidisciplinary approach before the development of respiratory tract symptoms.

Objectives: To evaluate the risk factors of recurrent pulmonary exacerbation and poor prognosis in children with idiopathic pulmonary hemosiderosis (IPH).  Methods: In this multicenter study, 54 patinets with diagnosis of IPH included. Medical records were retrospectively reviewed from three tertiary care hospitals between 1979 and 2019. Also, current information and the long-term progress of patients was determined by contacting the families by telephone. Results: A total of 54 children were included. The median age of onset of symptoms was 4.5 ± 3.8 years. The median time from onset to diagnosis was 0.9 years ± 2.2. The mean number of recurrent episodes per child in the recurrence-positive group was 3.55 (1-15). Univariate analysis demonstrated that patients presenting with hypoxia or requiring transfusion at the time of presentation had significantly more recurrence episodes (P=0.002). Multivariate analysis showed that the presence of hypoxia at the time of initial presentation was a significant independent predictor of recurrent episodes (P=0.027). The median follow-up was 3.3 ± 4.8 years (0.75 months-27 years). There was a significant relationship between the presence of hypoxia, transfusion history, ANA positivity, and elevated transaminases at the time of initial evaluation and treatment response. Conclusions: The present study provides important information on the clinical course and outcome of pediatric IPH, and substantial information regarding factors that affect recurrent exacerbations and prognosis. Demonstrating of hypoxia as an independent risk factor in recurrence episodes could be guide physicians in the planning of treatment strategies.