Format

Send to

Choose Destination
See comment in PubMed Commons below
Eur J Cardiothorac Surg. 2014 Aug;46(2):280-5; discussion 285. doi: 10.1093/ejcts/ezt617. Epub 2014 Jan 20.

Treatment strategies in the management of severe complications following slide tracheoplasty in children.

Author information

1
Pediatric Airway Unit and Pediatric Surgery Division, Department of Pediatrics, Hospital U. 12 de Octubre, Universidad Complutense, Madrid, Spain juan.antonpacheco@salud.madrid.org janton.hdoc@salud.madrid.org.
2
Pediatric Airway Unit and Pediatric Surgery Division, Department of Pediatrics, Hospital U. 12 de Octubre, Universidad Complutense, Madrid, Spain.
3
Division of Pediatric Anesthesiology, Hospital U. 12 de Octubre, Madrid, Spain.

Abstract

OBJECTIVES:

This study focuses on the different surgical and endoscopical treatment alternatives when dealing with severe complications after slide tracheoplasty (STP).

METHODS:

Retrospective study of patients with symptomatic congenital tracheal stenosis (CTS) admitted to a single institution, between January 1997 and January 2013, surgically treated by means of STP. The following variables were evaluated: demographics, preoperative tracheal stenosis characteristics, associated anomalies and outcome measures.

RESULTS:

Cohort included 14 patients (8 males and 6 females) with a mean age of 8.7 months when treated (range, 1-43 m). Eleven patients (78%) showed a long segment CTS (>30% of total tracheal length) and 9 (64%) had associated cardiac or great vessel anomalies (left pulmonary artery sling). Three patients (21%) showed severe postoperative complications that required significant airway reintervention: tracheal resection of a restenotic segment, laser division with balloon dilatation of a residual stenosis and placement of a biodegradable endotracheal stent in an extensive tracheal narrowing. All patients are in good clinical condition with a mean follow-up of 6.3 years (range, 2 months to 16 years).

CONCLUSIONS:

STP has become the procedure of choice when dealing with CTS. Although it shows clear advantages compared with other surgical techniques, severe and difficult to manage complications may occur. Surgeons involved in their treatment should be familiar with diverse surgical and endoscopical procedures. Biodegradable airway stenting is a new and promising technique when long and severe post-surgical tracheal stenosis is present.

KEYWORDS:

Biodegradable airway stent; Bronchoscopy; Children; Slide tracheoplasty; Tracheal stenosis

PMID:
24446477
DOI:
10.1093/ejcts/ezt617
[Indexed for MEDLINE]
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Silverchair Information Systems
    Loading ...
    Support Center