Abstract
Purpose
The aim of this study was to determine the appropriate surgical intervention strategies for congenital tracheal stenosis (CTS) associated with a tracheal bronchus based on the location of stenosis.
Methods
The medical records of 13 pediatric patients with CTS associated with a tracheal bronchus at a single institution between January 2006 and December 2015 were retrospectively reviewed.
Results
Type 1: tracheal stenosis above the right upper lobe bronchus (RULB) (n = 1). One patient underwent slide tracheoplasty and was successfully extubated. Type 2: tracheal stenosis below the RULB (n = 7). Tracheal end-to-end anastomosis was performed before 2014, and one patient failed to extubate. Posterior–anterior slide tracheoplasty was performed since 2014, and all three patients were successfully extubated. Type 3: tracheal stenosis above the RULB to the carina (n = 5). One patient underwent posterior–anterior slide tracheoplasty and was successfully extubated. Two patients with left–right slide tracheoplasty and another two patients with tracheal end-to-end anastomosis for the stenosis below the RULB could not be extubated.
Conclusion
Tracheal end-to-end anastomosis or slide tracheoplasty can be selected for tracheal stenosis above the RULB according to the length of stenosis. Posterior–anterior slide tracheoplasty appears feasible for tracheal stenosis below the RULB or above the RULB to the carina.
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References
Barat M, Konrad HR (1987) Tracheal bronchus. Am J Otolaryngol 8:118–122
Speggiorin S, Torre M, Roebuck DJ, McLaren CA, Elliott MJ (2012) A new morphologic classification of congenital tracheobronchial stenosis. Ann Thorac Surg 93:958–961. doi:10.1016/j.athoracsur.2011.12.019
Wang S, Zhang H, Zhu L, Zhen J, Liu J, Xu Z (2015) Surgical management of congenital tracheal stenosis associated with tracheal bronchus and congenital heart disease. Eur J Cardiothorac Surg. doi:10.1093/ejcts/ezv317 (Epub ahead of print)
Tsang V, Murday A, Gillbe C, Goldstraw P (1989) Slide tracheoplasty for congenital funnel-shaped tracheal stenosis. Ann Thorac Surg 48:632–635
Grillo HC (1994) Slide tracheoplasty for long-segment congenital tracheal stenosis. Ann Thorac Surg 58:613–619 (discussion 619–21)
Stock C, Nathan M, Murray R, Rahbar R, Fynn-Thompson F (2015) Modified end-to-end anastomosis for the treatment of congenital tracheal stenosis with a bridging bronchus. Ann Thorac Surg 99:346–348. doi:10.1016/j.athoracsur.2014.06.084
Wright CD, Graham BB, Grillo HC, Wain JC, Mathisen DJ (2002) Pediatric tracheal surgery. Ann Thorac Surg 74:308–313 (discussion 314)
Elliott M, Roebuck D, Noctor C, McLaren C, Hartley B, Mok Q, Dunne C, Pigott N, Patel C, Patel A, Wallis C (2003) The management of congenital tracheal stenosis. Int J Pediatr Otorhinolaryngol 67(Suppl 1):S183–S192
Beierlein W, Elliott MJ (2006) Variations in the technique of slide tracheoplasty to repair complex forms of long-segment congenital tracheal stenosis. Ann Thorac Surg 82:1540–1542
Yokoi A, Arai H, Bitoh Y, Nakao M, Oshima Y, Nishijima E (2012) Aortopexy with tracheal reconstruction for postoperative tracheomalacia in congenital tracheal stenosis. J Pediatr Surg 47:1080–1083. doi:10.1016/j.jpedsurg.2012.03.009
Salassa JR, Pearson BW, Payne WS (1977) Gross and microscopical blood supply of the trachea. Ann Thorac Surg 24:100–107
Madariaga ML, Gaissert HA (2016) Reresection for recurrent stenosis after primary tracheal repair. J Thorac Dis 8(Suppl 2):S153–S159. doi:10.3978/j.issn.2072-1439.2016.01.66
Le Bret E, Teissier N, Belli E, Sigal-Cinqualbre A, Couloignier V, Narcy P, Demontoux S, Gharbi N, Roussin R, Van Den Abbeele T, Serraf A (2006) Slide tracheoplasty in the presence of tracheal bronchus in an infant. J Thorac Cardiovasc Surg 132:e15–e16
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Morita, K., Yokoi, A., Fukuzawa, H. et al. Surgical intervention strategies for congenital tracheal stenosis associated with a tracheal bronchus based on the location of stenosis. Pediatr Surg Int 32, 915–919 (2016). https://doi.org/10.1007/s00383-016-3928-8
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DOI: https://doi.org/10.1007/s00383-016-3928-8