Treatment of Tracheal Stenoses by Resection in Infancy and Early Childhood

Salzer, G; Hartl, H; Wurnig, P

doi:10.1007/978-3-642-71665-2_10

Cited by 7 publications

(4 citation statements)

References 9 publications

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“…40,44,[50][51][52] Theoretically, this technique maintains a normal tracheal diameter; however, anastomotic tension may cause sutures to cut through, leading to fibrosis, scarring, and the potential for recurrent stenosis. Nevertheless, a number of reported series have demonstrated excellent outcomes using tracheal resection in selected patients with short segment tracheal stenosis.…”

Section: Resection and Primary Anastomosismentioning

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: Resection and Primary Anastomosismentioning

confidence: 99%

Management of Congenital Tracheal Stenosis

Hofferberth¹,

Watters

Rahbar

et al. 2015

PEDIATRICS

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“…[65][66][67] Resection and primary anastomosis (end-to-end anastomosis) Primary resection of the stenotic segment and reconstruction by end-to-end anastomosis is the treatment of choice for short-segment tracheal stenosis. 4,55,56,68,69 Because resection and primary anastomosis brings together each tracheal end with a normal diameter, this procedure should theoretically result in near-perfect duplication of the normal anatomy. However, depending on the degree of tension separating the anastomosis related to the length of the resected trachea, sutures may cut through, resulting in partial or complete separation, and leading to fi brosis, scar formation, and recurrent stenosis.…”

Section: Surgical Managementmentioning

confidence: 99%

Surgical management of congenital tracheal stenosis

Terada

Hotoda

Toma

et al. 2009

Gen Thorac Cardiovasc Surg

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Congenital tracheal stenosis (CTS) is a rare but life-threatening disorder, particularly in neonates and infants. The stenotic lesions are commonly composed of complete rings of cartilage varying in length, location, and severity. A definitive diagnosis of CTS may be delayed because of the rarity of this disorder and thus its unfamiliarity among physicians, its variable onset time, its various clinical symptoms, and the diversity of associated clinical conditions due to the cardiovascular disorders that may accompany it. More than half of the patients who manifest clinical symptoms during early infancy show a long-segment stenosis. Long-segment CTS is problematic and challenging to manage. Over the last two decades several surgical techniques for long-segment CTS have been devised and developed, but no definitively advantageous surgical procedure has been established because of insufficient experience and the lack of large-scale studies. Although rib cartilage tracheoplasty and pericardial patch tracheoplasty have provided limited early to midterm success for infants with long-segment CTS, these procedures are associated with early and late complications, including granulation tissue formation, patch collapse, and restenosis necessitating reintervention. By contrast, slide tracheoplasty has given rise to better surgical outcomes. This procedure enables reconstruction of the stenotic trachea using native tracheal walls with preserved blood supply. The trachea is foreshortened by only one-half of the original stenosis, resulting in reduced tension on the anastomosis. Consequently, the technique has several advantages, including less formation of granulation tissue, satisfactory subsequent growth, and infrequent reoperation for restenosis. Slide tracheoplasty is currently recognized as the preferred technique for long-segment CTS.

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“…While slide tracheoplasty is the procedure of choice for patients with CTS having complex airway lesions, primary resection of the stenosed tracheal segment and reconstruction by end-to-end anastomosis remains a suitable operative choice for patients with short-segment CTS. 22,[28][29][30] Several series have demonstrated excellent outcomes using tracheal resection in selected patients with short-segment tracheal stenosis, with a global morality rate of less than 9%. 28,31,32 Our results support the use of tracheal resection and primary anastomosis in patients with discreet short-segment CTS.…”

Section: Commentmentioning

confidence: 99%