title: Slide tracheoplasty outcomes in children with congenital pulmonary malformations.
abstract: Evaluate and compare surgical outcomes of slide tracheoplasty for the treatment of congenital tracheal stenosis in children with and without pulmonary malformations.
  
  
  
  Retrospective chart review at a tertiary care pediatric medical center.
  
  
  
  We identified patients with tracheal stenosis who underwent slide tracheoplasty from 2001 to 2014, and a subset of these patients who were diagnosed with congenital pulmonary malformations. Hospital course and preoperative and postoperative complications were recorded.
  
  
  
  One hundred thirty patients (18 with pulmonary malformations, 112 with normal pulmonary anatomy) were included. Pulmonary malformations included unilateral pulmonary agenesis (61%) and hypoplasia (39%). Children with pulmonary malformations had a greater median age compared to their normal lung anatomy counterparts. Preoperatively, patients with pulmonary malformations more frequently required preoperative mechanical ventilation (55.6% vs. 21.3%, P = .007), extracorporeal membrane oxygenation (ECMO) (11% vs. 0.9%, P = .05), and tracheostomy (22.2% vs. 3.6%, P = .01). Postoperatively, patients with pulmonary malformations more frequently required mechanical ventilation >48 hours (78% vs. 37%, P =.005) and ECMO use (11% vs. 0.9%, P = .05). Pulmonary malformation patients and children with normal anatomy did not differ in terms of postoperative tracheostomy (16.7% vs. 4.4%, P > .05), dehiscence (6% vs. 0%, P > .05%), restenosis (11% vs. 6%, P > .05) or postoperative figure 8 deformity (6% vs. 3%, P > .05). Mortality, however, was significantly increased (22.2% vs. 3.6%, P = .01) in children with pulmonary malformations.
  
  
  
  Although slide tracheoplasty can be successfully performed in patients with abnormal pulmonary anatomy, surgeons and families should anticipate a more difficult postoperative course, with possible associated prolonged mechanical ventilation, ECMO use, and higher mortality than in children with tracheal stenosis alone.
  
  
  
  4. Laryngoscope, 127:1283-1287, 2017.
authors.affiliation: Division of Pediatric Otolaryngology-Head and Neck Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, U.S.A.
authors.forename: Michael A
authors.initials: MA
authors.lastname: DeMarcantonio
authors.affiliation: Division of Pediatric Otolaryngology-Head and Neck Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, U.S.A.|Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, U.S.A.
authors.forename: Catherine K
authors.initials: CK
authors.lastname: Hart
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Montefiore Medical Center, Bronx, New York, U.S.A.
authors.forename: Christina J
authors.initials: CJ
authors.lastname: Yang
authors.affiliation: Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, U.S.A.
authors.forename: Meredith
authors.initials: M
authors.lastname: Tabangin
authors.affiliation: Division of Pediatric Otolaryngology-Head and Neck Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, U.S.A.|Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, U.S.A.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Rutter
authors.affiliation: The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, U.S.A.|Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, U.S.A.
authors.forename: Roosevelt
authors.initials: R
authors.lastname: Bryant
authors.affiliation: Division of Cardiothoracic Surgery, Washington University, St. Louis, Missouri, U.S.A.
authors.forename: Peter B
authors.initials: PB
authors.lastname: Manning
authors.affiliation: Division of Pediatric Otolaryngology-Head and Neck Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, U.S.A.|Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, U.S.A.
authors.forename: Alessandro
authors.initials: A
authors.lastname: de Alarcón
mesh_terms: D002675:Child, Preschool; D015199:Extracorporeal Membrane Oxygenation; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D011183:Postoperative Complications / Q000209:etiology* / Q000401:mortality; D019651:Plastic Surgery Procedures / Q000009:adverse effects* / Q000379:methods; D012121:Respiration, Artificial; D015619:Respiratory System Abnormalities / Q000601:surgery*; D012189:Retrospective Studies; D014132:Trachea / Q000002:abnormalities / Q000601:surgery*; D014135:Tracheal Stenosis / Q000151:congenital / Q000601:surgery*; D016896:Treatment Outcome
keywords: Slide tracheoplasty; complete tracheal rings; pulmonary agenesis; pulmonary hypoplasia; tracheal stenosis