title: Evolution of Surgical Approaches in the Management of Congenital Tracheal Stenosis: Single-Center Experience.
abstract: BACKGROUND
  Congenital tracheal stenosis (CTS) is a serious and rare condition that often presents a complex surgical challenge. We reviewed the evolution of surgical approaches to the management of CTS at a single institution.
  
  
  METHODS
  We conducted a retrospective clinical review of all patients who underwent surgical repair of CTS at our institution. From January 1992 to January 2014, a total of 30 patients (median age 92 days; range 3 days-1.7 years) underwent surgery for CTS at our institution. Techniques included slide tracheoplasty (n = 16), tracheal resection (n = 10), pericardial patch tracheoplasty (n = 3), and costal cartilage tracheoplasty (n = 1). Twenty-two (73%) patients had associated intracardiac or great vessel anomalies, including 18 (60%) with left pulmonary artery sling. Five (17%) patients had associated single lung malformation. All procedures were performed via a median sternotomy with cardiopulmonary bypass.
  
  
  RESULTS
  Median postoperative length of stay was 25 days (range, 5-431 days). Late airway reintervention was required in seven (26%), including two (15%) infants after slide tracheoplasty, two (22%) posttracheal resection, and two (100%) post pericardial patch tracheoplasty. The one patient who underwent costal cartilage tracheoplasty required multiple reinterventions. Overall mortality was 13% (n = 4), two deaths occurred post slide tracheoplasty, one death occurred after tracheal resection, and one after pericardial patch tracheoplasty, respectively.
  
  
  CONCLUSIONS
  Slide tracheoplasty is the procedure of choice for repair of CTS, while tracheal resection is a viable option for patients with discreet, short-segment stenosis.
authors.affiliation: Department of Cardiac Surgery, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: Sophie C
authors.initials: SC
authors.lastname: Hofferberth
authors.affiliation: Department of Otolaryngology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: Karen
authors.initials: K
authors.lastname: Watters
authors.affiliation: Department of Otolaryngology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: Reza
authors.initials: R
authors.lastname: Rahbar
authors.affiliation: Department of Cardiac Surgery, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA francis.fynn-thompson@cardio.chboston.org.
authors.forename: Francis
authors.initials: F
authors.lastname: Fynn-Thompson
mesh_terms: D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D056346:Sternotomy / Q000379:methods*; D014135:Tracheal Stenosis / Q000151:congenital / Q000601:surgery*; D016896:Treatment Outcome
keywords: airway; trachea; tracheal stenosis; tracheal surgery