Slide Tracheoplasty for Congenital Tracheal Stenosis Repair: A Systematic Review and Meta‐Analysis

Abstract

Objectives: Congenital tracheal stenosis (CTS) is a rare but life-threatening condition in children. At present, slide tracheoplasty has been advocated as the preferred technique for most cases of CTS. However, the morbidity and mortality subsequent to slide tracheoplasty need further elaboration. Therefore, a meta-analysis was performed on the outcomes of slide tracheoplasty in children with CTS.Study Design: Systematic review and meta-analysis. Methods: Electronic databases, including PubMed, Embase, and Cochrane Library CENTRAL, were systematically searched for the period from January 1990 to March 2021 for literature that reported clinical outcomes of slide tracheoplasty for children with CTS. Meta-regression and subgroup analyses were performed to determine the risk factors for in-hospital mortality and airway reinterventions.Results: A total of 25 studies involving 577 patients were included. For children with CTS, in-hospital and overall mortality after slide tracheoplasty was 6.1% (95% CI = 4.2%-8.0%) and 9.7% (95% CI = 7.3%-12.1%), respectively. The incidence of airway reinterventions was 23.0% (95% CI = 15.6%-30.5%). The length of postoperative ventilation and hospital stay was 6.8 days (95% CI = 5.1-8.4 days) and 19.2 days (95% CI = 15.8-22.7 days), respectively. Postoperative complications occurred in 46.6% (95% CI = 35.8%-57.4%) of all patients. Meta-regression analysis showed that a higher proportion of the recently published studies reported significantly better in-hospital survival (coefficient À0.011, P = .021).Conclusions: In conclusion, in-hospital mortality after slide tracheoplasty is 6.1%, and the incidence of airway reinterventions is 23.0%. In-hospital mortality after slide tracheoplasty has decreased chronologically.

Pädiatrische Atemwegschirurgie: Indikationen und Techniken

“…In einer Metaanalyse von 577 Patienten nach Slide Tracheoplasty wurde die Krankenhausmortalität mit 6,1 % angegeben. Dies ist insbesondere der höheren Mortalität in den früheren Publikationen geschuldet und muss im Kontext der oft syndromalen Fehlbildungen bewertet werden [26]. Insgesamt stellt die Slide Tracheoplasty an erfahrenen Zentren eine chirurgische Behandlungsoption mit guten Ergebnissen dar.…”