Document Detail

Slide tracheoplasty for long-segment tracheal stenosis.
MedLine Citation:
PMID:  9440789     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To introduce a novel surgical technique for the repair of congenital long-segment tracheal stenosis. DESIGN: Retrospective case series. SETTING: Tertiary-care hospital. PATIENTS: Three children ranging in age from 3 months to 3 years, all with complete tracheal rings, the stenotic segments representing between 36% and 49% of the total tracheal length. One patient had an anomalous right upper lobe bronchus and an associated pulmonary artery sling. INTERVENTION: Slide tracheoplasty reconstruction. MAIN OUTCOME MEASURE(S): Postoperative clinical status as evidenced by day and site of extubation, duration of hospitalization, number of bronchoscopic examinations performed before discharge, and subsequent need for urgent bronchoscopic examinations, which reflects the adequacy of the reconstructed airway. RESULTS: Two patients were extubated on the day of surgery, 1 intraoperatively; the child with the pulmonary artery sling required 3 days of elective intubation for postoperative ventilatory support. The duration of hospitalization ranged from 8 to 10 days. All patients underwent elective bronchoscopy once before discharge; none had granuloma formation. Follow-up ranged from 1 to 4 1/2 years. One patient required a single urgent bronchoscopic examination in addition to planned surveillance endoscopy. Growth of the reconstructed hemitracheal rings is demonstrable. CONCLUSIONS: Slide tracheoplasty achieves successful tracheal reconstruction using the patient's own tracheal tissues. Advantages of this method include the potential avoidance of cardiopulmonary bypass, immediate or early postoperative extubation, and the near-complete absence of granulation tissue formation. The latter obviates the need for multiple postoperative bronchoscopic examinations, as has been reported in tracheoplasty procedures using either costal cartilage or pericardium.
M J Cunningham; R D Eavey; G J Vlahakes; H C Grillo
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Archives of otolaryngology--head & neck surgery     Volume:  124     ISSN:  0886-4470     ISO Abbreviation:  Arch. Otolaryngol. Head Neck Surg.     Publication Date:  1998 Jan 
Date Detail:
Created Date:  1998-02-06     Completed Date:  1998-02-06     Revised Date:  2006-03-28    
Medline Journal Info:
Nlm Unique ID:  8603209     Medline TA:  Arch Otolaryngol Head Neck Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  98-103     Citation Subset:  AIM; IM    
Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston 02114, USA.
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MeSH Terms
Child, Preschool
Follow-Up Studies
Otorhinolaryngologic Surgical Procedures / methods
Tomography, X-Ray Computed
Tracheal Stenosis / congenital,  radiography,  surgery*

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