Slide tracheoplasty.
OBJECTIVE
The current practice of slide tracheoplasty for children with long-segment tracheal stenosis is reviewed.


RESULTS
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.


CONCLUSIONS
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 Previous operations have been superseded by the advent of slide tracheoplasty in combination with a multidisciplinary approach with balloon dilatation and, occasionally, stenting in cases of recurrent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.
Elliott
Martin
M
Department of Cardiothoracic Surgery, Great Ormond Street Hospital for Children NHS Trust, London, UK. elliom1@gosh.nhs.uk
Hartley
Benjamin E J
BE
Wallis
Colin
C
Roebuck
Derek
D
D002404:Catheterization; D002648:Child; D006801:Humans; D011183:Postoperative Complications; D011788:Quality of Life; D012008:Recurrence; D016879:Salvage Therapy; D015607:Stents; D015996:Survival Rate; D014135:Tracheal Stenosis / Q000151:congenital* / Q000401:mortality / Q000601:surgery*