Slide tracheoplasty for long-segment congenital tracheal stenosis

Abstract

Resection and reconstruction of long congenital tracheal stenosis often is impossible or results in excessive anastomotic tension. Anterior tracheoplasty using a patch of pericardium or cartilage may result in granulation tissue needing repeated bronchoscopies, tracheostomy, and stents and may produce recurrent stenosis. Tracheoplasty may be performed by dividing the stenosis at midpoint, incising the proximal and distal narrowed segments vertically on opposite anterior and posterior surfaces and sliding these together. The stenotic segment is shortened by half, the circumference doubled, and the lumenal cross-section quadrupled. Approach is cervical or with partial sternotomy. Cardiopulmonary bypass is not necessary. Four patients (ages: 3 months, 3 1/2 years, 19 years, and 19 years) were so treated for stenosis of 36% to 83% of tracheal length. Blood supply was not impaired. Healing was excellent and complications were minimal.