Management of congenital tracheal stenosis.
OBJECTIVE
Congenital tracheal stenosis is a rare disease. Various methods for treatment exist but there is still much debate as to the appropriate surgical procedure. We present our surgical experiences of patch tracheoplasty and slide tracheoplasty as viable methods for the treatment of congenital tracheal stenosis.


METHODS
From 1994 to 2002, 13 patients were diagnosed with congenital tracheal stenosis. Eight patients (7 symptomatic and 1 asymptomatic) had their stenosis corrected, three by means of pericardial patch tracheoplasty, four by slide tracheoplasty, and one by resection and anastomosis. Concomitant operations were performed on six patients to treat congenital cardiovascular disease. Five patients showing no significant symptoms did not undergo tracheal surgery and received only cardiac procedures. A retrospective review of the hospital course, complications, and long-term results was conducted.


RESULTS
Among the patch tracheoplasty group, every patient suffered from granulation tissue formation. One patient died of respiratory acidosis and one was hospitalized due to recurrent granulation tissue, which required frequent bronchoscopy. The third patient from this group is free of all symptoms. Among the slide tracheoplasty group, one patient died of anastomosis disruption. The three remaining patients are alive and well. The one patient who received resection and anastomosis is alive without symptoms.


CONCLUSIONS
Surgical repair of long-segment congenital tracheal stenosis exhibited high mortality and morbidity rates. Every patient that underwent pericardial patch tracheoplasty suffered from troublesome granulation tissue. As slide tracheoplasty provided relatively good results in the short and mid-term follow-up periods, it seems to be a preferred method for the treatment of long-segment congenital tracheal stenosis.
Kim
Hong Kwan
HK
Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Cancer Research Institute, Xenotransplantation Research Center, Clinical Research Institute, Seoul National University College of Medicine, Seoul 110-744, South Korea.
Kim
Young Tae
YT
Sung
Sook Whan
SW
Park
June Dong
JD
Kang
Chang Hyun
CH
Kim
Joo Hyun
JH
Kim
Yong Jin
YJ
D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010496:Pericardium / Q000637:transplantation; D011183:Postoperative Complications; D011379:Prognosis; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D014135:Tracheal Stenosis / Q000151:congenital* / Q000000981:diagnostic imaging / Q000601:surgery*