Clinical outcomes of slide tracheoplasty in congenital tracheal stenosis.

Abstract

OBJECTIVES:

Treatment of long-segment congenital tracheal stenosis (CTS) remains challenging. Recently, slide tracheoplasty has become the standard approach in many centres. The aim of this study was to evaluate the clinical outcomes of slide tracheoplasty.

METHODS:

Between 2004 and 2011, 18 patients underwent slide tracheoplasty in our centre. The median patient age was 2.5 months (range, 18 days-4 years) and the median body weight was 4.2 (range, 2.2-17.7) kg at operation. Eleven (61%) patients were on a mechanical ventilator prior to surgery. The median stenotic segment estimated by a computed tomography scan was 52% of the length of total trachea (range, 18-84%). Five (28%) patients had proximal bronchial stenosis, 3 (17%) had tracheal bronchus, 2 (11%) had tracheobronchomalacia and 1 (6%) had agenesis of the right lung. Thirteen (72%) patients had a combined cardiac anomaly, including 8 patients with a pulmonary artery sling. Ten (56%) patients had associated extracardiac anomalies. Slide tracheoplasty was performed on cardiopulmonary bypass in all patients, and cardiac lesions were corrected.

RESULTS:

There was no early death. The patient with agenesis of the right lung died of left bronchial stenosis 3 months after the surgery. Two (11%) patients were reoperated on for tracheal restenosis. In the other 15 patients, the median duration of ventilator support was 8 (range, 5-34) days and the median duration of hospitalization was 31 (range, 12-79) days. During the follow-up (median duration of 17 months; range, 2-77 months), 13 (72%) patients were symptom-free and 2 (11%) underwent tracheostomy for tracheomalacia.

CONCLUSIONS:

Based on this study, slide tracheoplasty seems to be an effective technique for CTS. However, shortening of the trachea after reconstruction may give rise to recurrent obstruction.

• Authors: Su Ryeun Chung, Ji-Hyuk Yang, Tae-Gook Jun, Wook Sung Kim, Yong Han Kim, I-Seok Kang, June Huh, Jin Young Song, Joongbum Cho
• Journal: European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery (Eur J Cardiothorac Surg) Vol. 47 Issue 3 Pg. 537-42; discussion 542 (Mar 2015) ISSN: 1873-734X [Electronic] Germany
• PMID: 24819360 (Publication Type: Journal Article)
• Copyright: © The Author 2014. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

Topics

• Airway Extubation
• Cardiopulmonary Bypass
• Child, Preschool
• Humans
• Infant
• Infant, Newborn
• Length of Stay
• Postoperative Complications
• Plastic Surgery Procedures (adverse effects, methods, statistics & numerical data)
• Retrospective Studies
• Thoracic Surgical Procedures (adverse effects, methods, statistics & numerical data)
• Trachea (surgery)
• Tracheal Stenosis (epidemiology, surgery)
• Treatment Outcome