Surgical approach to funnel-shaped congenital tracheal stenosis

Matute, J A; Romero, R.; García-Casillas, M A; Agustín, Juan Carlos de; Marhuenda, C; Berchi, F. J.; Vázquez, Juan José

doi:10.1053/jpsu.2001.20706

Cited by 31 publications

(24 citation statements)

References 17 publications

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“…3,34,36 The contemporary management of CTS at major tertiary centers involves an integrated, multidisciplinary team approach with expertise in cardiothoracic surgery, otolaryngology, cardiology, pulmonology, and anesthesiology. 13,25,33 An important consideration is that inappropriate or untimely intervention has potential to precipitate a critical airway event in patients with CTS.…”

Section: Therapeutic Approaches and Treatment Indicationsmentioning

confidence: 99%

Management of Congenital Tracheal Stenosis

Hofferberth¹,

Watters

Rahbar

et al. 2015

PEDIATRICS

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Congenital tracheal stenosis (CTS) is a serious and rare condition. In most cases, stenotic lesions are composed of complete tracheal rings of cartilage. The severity of symptoms correlates with the length of affected trachea, the presence of concomitant respiratory conditions, degree of luminal narrowing, and any bronchial involvement. Critically, CTS is a disorder that can lead to life-threatening respiratory insufficiency in children. Thus, it is a clinical entity that demands timely diagnosis and treatment. This review will firstly discuss the anatomy and pathophysiology of CTS and outline the various clinical presentations associated with the disorder. In addition, methods of diagnosis and treatment strategies will be reviewed, with a focus on contemporary surgical techniques. Finally, postoperative care of patients with CTS will be reviewed, and a contemporary multidisciplinary management approach will be presented.

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Section: Therapeutic Approaches and Treatment Indicationsmentioning

confidence: 99%

Management of Congenital Tracheal Stenosis

Hofferberth¹,

Watters

Rahbar

et al. 2015

PEDIATRICS

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“…3,7,12 Successful extubation within 48 hours of surgery has occurred in over 52% of our long-segment congenital tracheal stenosis patients, reducing the need for sedation and paralysis that would be given to protect an intubated patient's airway. 13 It also reduces the risk of wound necrosis or dehiscence caused by the endotracheal tube lying on a fresh anastomosis.…”

Section: Discussionmentioning

confidence: 99%

“…Slide tracheoplasty is advantageous because it avoids the use of graft material, has a high early-extubation success rate, and is associated with better long-term out-comes. 7,8 However, despite improvements in surgical techniques, slide tracheoplasty has risks for important complications. 9 We report successful management of a patient with unilateral (right) pulmonary agenesis and long-segment tracheal and left bronchial stenosis, and who had tracheal dehiscence of the anastomosis site following slide tracheoplasty.…”

Section: Introductionmentioning

confidence: 99%

Extracorporeal Membrane Oxygenation, Extubation, and Lung-Recruitment Maneuvers as Rescue Therapy in a Patient With Tracheal Dehiscence Following Slide Tracheoplasty

et al. 2011

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Long-segment congenital tracheal stenosis is characterized by complete tracheal rings. Surgery is required during infancy to optimize outcomes, and the post-surgery complications include mucus plugging, airway trauma, dehiscence at the surgery site, and death. We report a 5-week-old patient who developed a tracheal-wall dehiscence after a slide tracheoplasty. To safeguard against further dehiscence and to protect her one functional lung, we used extracorporeal membrane oxygenation (ECMO). After she was stabilized on veno-arterial ECMO we extubated and continued ECMO for 5 days. On postoperative day 14 we removed the ECMO and transitioned her to high-frequency oscillatory ventilation, and performed slow lung-recruitment maneuvers every 2 hours. This strategy of ECMO with extubation, then high-frequency oscillatory ventilation is a useful rescue therapy in patients with postoperative tracheal dehiscence.

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“…These advantages include immediate tracheal reconstruction with rigid, vascularized tissue with a normal mucosa; ability to extubate patients early in many cases; less postoperative granulation tissue formation; and growth potential of the reconstructed trachea (7,33). In addition, it is a versatile technique: one can perform a short-segment slide, an oblique slide, or even an inverse slide if circumstances dictate.…”

Section: Slide Tracheoplastymentioning

confidence: 99%

“…A retrospective series by Matúte et al (n=10) compared the slide procedure with anterior costal cartilage graft tracheoplasty (ACCGT) for the treatment of CTRs, reporting that all six patients treated by ACCGT experienced restenosis while the four patients treated with slide tracheoplasty were asymptomatic and doing well (33).…”

Section: Slide Tracheoplastymentioning

confidence: 99%