Slide tracheoplasty for severe congenital long segment tracheal stenosis in infants: surgical and anesthetic management.
Congenital long segment tracheal stenosis is the rare occurrence of an intrinsic narrowing of the trachea due to a complete cartilagenous ring. It is difficult to manage and can be life threatening especially when these patients who are usually neonates or infants have the pathological pattern of a long segment and have to come for surgical correction. Despite many technical reports on how to correct this anormaly, currently, the technique of "slide tracheoplasty" is claimed to be the most successful with the good immediate and long-term outcomes. But because of the rare and life threatening disease, so we were encouraged and write this report about the disease and its management. These are the case series reports of 4 infants with a history and diagnosis of severe long segment congenital tracheal stenosis who needed a difinite surgical repair. The authors decided to use the surgical technique of "slide tracheoplasty" with successful outcome. In two of the cases, patients needed cardioplumonary bypass support during the surgical repair. All of these patients did well after the operation except one patient with a history of congenital heart disease (tetralogy of Fallot) who needed an emergency surgical repair and was reoperated upon with pericardial patch. In this reports the authors did not find any benefit from tracheostomy. Also, details of surgical and anesthetic procedure were discussed with the conclusion that the surgical technique of slide tracheoplasty should be the surgical of choice for the management of congenital long segment tracheal stenosis.
Laohapansang
Mongkol
M
Section of Pediatric Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.
Phanchaipetch
Teerawit
T
Kongsayreepong
Suneerat
S
Ungkanont
Kittirat
K
D000768:Anesthesia, General / Q000379:methods; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D011379:Prognosis; D019651:Plastic Surgery Procedures; D014132:Trachea / Q000601:surgery*; D014135:Tracheal Stenosis / Q000151:congenital* / Q000175:diagnosis / Q000601:surgery*