Long-distance resection of the trachea with primary anastomosis in small children

While tracheal resection with primary anastomosis has been accepted as the therapy of choice for tracheal stenoses in adults since the 1960s, only 26 case reports are available on continuity resections of the trachea in children. The advantages of continuity resection include the one-stage procedure and the preservation of the natural wall structures. Anastomosis should be accomplished with pericartilaginous sutures and absorbable suture material. The increased tension on anastomoses inserted following resection of long tracheal segments does not necessarily have a negative influence on wound healing. The case histories of three small children are given in this report: they all underwent tracheal continuity resections involving four or five rings because of postintubation stenoses. The results of resection after up to 5 years' follow-up are very good, so that this method can be recommended in preference to the reconstructive tracheoplasty in children, which takes longer. If the cricoid cartilage is also involved a combination of tracheal resection and cricoid resection/dilatation is recommended.