Purpose Of Review: The current practice of slide tracheoplasty for children with long-segment tracheal stenosis is reviewed.
Recent Findings: In our own series, the mortality for children with long-segment tracheal stenosis managed by slide tracheoplasty in the 5-year period between 1995 and 2000 was 43% (3/7), consistent with other series in the literature. In 2001, we developed a multidisciplinary approach with aggressive postoperative surveillance, intermittent balloon dilatation and selective stenting for salvage. Mortality fell to 11% over the next 5 years (2/18). Since 2005, 25 cases have been treated and hospital mortality has been eliminated (0%, 0/25). There has been one late death due to renal disease. Quality of life for survivors is good.
Summary: The outlook has changed substantially in recent years for children with long-segment tracheal stenosis. Previous operations have been superseded by the advent of slide tracheoplasty in combination with a multidisciplinary approach with balloon dilatation and, occasionally, stenting in cases of recurrent stenosis. Survival rates have risen dramatically.
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http://dx.doi.org/10.1097/MOO.0b013e3282f45ab7 | DOI Listing |
Ann Thorac Surg
December 2024
Paediatric Cardiothoracic and Tracheal Surgery, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.
Background: Long segmental congenital tracheal and tracheobronchial stenosis are a rare congenital airway anomaly with variable arborizations. This study aims to analyze presentations and outcomes of slide- tracheoplasty in long segmental congenital tracheal and tracheobronchial stenosis with variable arborizations METHODS: Retrospective analysis of all patients underwent slide tracheoplasty between March 1995 to Feb 2023 for long segmental congenital tracheal and tracheobronchial stenosis. Preoperative airway morphology was divided into anatomic types based on the Great Ormond Street Children Hospital Morphological Classification.
View Article and Find Full Text PDFJ Pediatr Surg
December 2024
Division of Pediatric Surgery, Department of Surgery, IRCCS Istituto Giannina Gaslini, Via Gerolamo Gaslini 5, 16147, Genova, Italy; Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, DINOGMI, Università di Genova, Largo Paolo Daneo 3, 16132, Genova, Italy; Pediatric Thoracic and Airway Surgery Unit, Department of Surgery, IRCCS Istituto Giannina Gaslini, Via Gerolamo Gaslini 5, 16147, Genova, Italy.
J Thorac Cardiovasc Surg
November 2024
Department of Laboratory Medicine, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, P.R. China. Electronic address:
Laryngoscope
November 2024
The Division of Pediatric Otolaryngology-Head and Neck Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
Interdiscip Cardiovasc Thorac Surg
September 2024
Department of Respiratory Medicine, Royal Children's Hospital, Melbourne, Australia.
Infant long-segment congenital tracheal stenosis (LTS) is rare and presents a challenging clinical scenario. We describe the management of a child who required extracorporeal membrane oxygenation following a respiratory arrest and underwent slide tracheoplasty in infancy for severe LTS and required repeated bronchoscopic reinterventions for recurrent tracheal granulations. At 9 years of age, the child has normal pulmonary function testing and a normal exercise tolerance.
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