Intermediate-Term Outcomes of Slide Tracheoplasty in Pediatric Patients With Ring-Sling Complex

This study was intended to determine the intermediate-term outcomes after slide tracheoplasty (STP) in patients with ring-sling complex.

All children undergoing STP between 2009 and 2018 were included. The patients' baseline characteristics, perioperative management details, and follow-up evaluations were reviewed retrospectively.

Median age was 1.2 years (range, 2 months to 9.2 years). Seventy-eight patients had additional cardiovascular anomalies and 7 had unilateral pulmonary hypoplasia. Carina involved in the stenotic lesion was present in 42 patients and carinal compression occurred in 58. Twenty-five (21.6%) patients had a stenosis extending into the main bronchus. Type 2, typically having aberrant tracheobronchial patterns, accounted for nearly two-thirds of the patients according to Wells' classification. There were 7 in-hospital deaths and 8 late deaths. Median follow-up was 2.1 years (range, 1.2 months to 9.2 years). Type 2B patients had a higher incidence of malacia and restenosis. In multivariate analysis, the additional cardiovascular anomaly was significantly associated with postoperative tracheomalacia (P = .037). Carinal stenosis (P = .034) was significantly associated with recurrent stenosis. Bronchial stenosis with concomitant carinal stenosis and compression was significantly associated with postoperative tracheomalacia, restenosis, and mortality (for all comparisons, P < .001).

Intermediate outcomes of STP in patients with ring-sling complex is satisfactory. Type 2B is a heterogenous subset patients with more severe tracheobronchial anomalies who will benefit from recognition preoperatively and close surveillance postoperatively.