title: Surgical management of congenital tracheal stenosis associated with tracheal bronchus and congenital heart disease.
abstract: OBJECTIVE
  Congenital tracheal stenosis (CTS) is variable in patients with tracheal bronchus and congenital heart disease (CHD). Tracheoplasty remains a high-risk surgical treatment.
  
  
  METHODS
  From January 2007 to December 2014, 24 CTS patients (10 males and 14 females; age 20.6 ± 13.6 months) with tracheal bronchus and CHD underwent one-stage surgical correction. Clinical features of all patients included dyspnoea, or recurrent pulmonary infections. There was long-segment CTS in 13 cases (54%), and 4 cases were associated with a bridging bronchus. Less than 50% of normal tracheal size was identified in 21 cases. Complete tracheal or bronchial rings were identified in all cases. Operative techniques included: tracheal end-to-end anastomosis in 11 cases and slide tracheoplasty in 13 cases, which included 11 cases of right upper lobe bronchus (RULB) opposite side-slide tracheoplasty.
  
  
  RESULTS
  There were 2 operative deaths, due to postoperative tracheomalacia or residual main bronchial stenosis. The duration of postoperative hospital stay was 7-59 days, with an average of 19 days. Follow-up was completed in 19 cases. The follow-up duration was from 1 month to 7 years. Tracheal granulation occurred in 1 case. Clinical symptoms were significantly improved in the remaining patients.
  
  
  CONCLUSIONS
  Tracheal bronchi have special anatomical features. The techniques of tracheal end-to-end anastomosis or side-slide tracheoplasty can be used to correct tracheal stenosis with satisfactory outcomes.
authors.affiliation: Department of Cardiac and Thoracic Surgery, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China.
authors.forename: Shunmin
authors.initials: S
authors.lastname: Wang
authors.affiliation: Department of Cardiac and Thoracic Surgery, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China.
authors.forename: Haibo
authors.initials: H
authors.lastname: Zhang
authors.affiliation: Department of Cardiac and Thoracic Surgery, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China.
authors.forename: Limin
authors.initials: L
authors.lastname: Zhu
authors.affiliation: Department of Cardiac and Thoracic Surgery, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China.
authors.forename: Jinghao
authors.initials: J
authors.lastname: Zhen
authors.affiliation: Department of Cardiac and Thoracic Surgery, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China.
authors.forename: Jinfen
authors.initials: J
authors.lastname: Liu
authors.affiliation: Department of Cardiac and Thoracic Surgery, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China zwxumd@hotmail.com.
authors.forename: Zhiwei
authors.initials: Z
authors.lastname: Xu
mesh_terms: D002675:Child, Preschool; D005260:Female; D006330:Heart Defects, Congenital / Q000601:surgery*; D006761:Hospitals; D006801:Humans; D007223:Infant; D008168:Lung / Q000000981:diagnostic imaging; D008297:Male; D011183:Postoperative Complications; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000379:methods*; D014135:Tracheal Stenosis / Q000601:surgery*
keywords: Bronchial disease; Complications; Congenital heart disease; Surgery; Tracheal stenosis