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Outcomes of slide tracheoplasty in 101 children: a 17-year single-center experience

Colin R Butler1, Simone Speggiorin1, Friso M Rijnberg1

  • 1The National Service for Severe Tracheal Disease in Children, Great Ormond Street Hospital for Children, National Health Service Foundation Trust, London, United Kingdom.

The Journal of Thoracic and Cardiovascular Surgery
|April 5, 2014
PubMed

Insights

Surgical slide tracheoplasty (STP) is effective for long segment tracheal stenosis in children, showing low mortality. Preoperative bronchomalacia is a key risk factor for mortality and need for stenting after the procedure.

Area of Science:

  • Pediatric Surgery
  • Thoracic Surgery
  • Respiratory Medicine

Background:

  • Long segment tracheal stenosis poses significant challenges in pediatric patients.
  • Previous surgical strategies have been associated with higher morbidity and mortality rates.

Purpose of the Study:

  • To evaluate the outcomes of surgical slide tracheoplasty (STP) in children with long segment tracheal stenosis.
  • To identify risk factors associated with mortality and need for further interventions post-STP.

Main Methods:

  • A retrospective review of 101 children undergoing STP between February 1995 and December 2012.
  • Data collected included demographic and preoperative conditions, operative details, and outcomes such as need for endoscopic intervention and mortality.
  • Multivariate analysis was used to identify adverse predictors of survival.

Main Results:

  • Overall survival was 88.2% in 101 patients. 71.3% had associated cardiovascular anomalies.
  • Preoperative bronchomalacia was a significant risk factor for mortality (P < .001) and postoperative stenting (P < .05).
  • 44.6% required post-STP balloon dilation and 21.8% required stenting.

Conclusions:

  • Surgical slide tracheoplasty is a versatile and reliable technique for pediatric long segment tracheal stenosis with low morbidity and mortality.
  • Preoperative bronchomalacia is a critical risk factor influencing survival and the need for postoperative stenting.
Abstract

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