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Complex tracheal resection in children: Myths, reality and lessons learned
Michele Torre1, Patricio Varela2, Diana Romero3
1Pediatric Thoracic and Airway Surgery Unit, IRCCS Giannina Gaslini, Genoa, Italy.
Seminars in Pediatric Surgery
|June 26, 2021
Summary
Complex tracheal resections, involving 30-50% of the trachea, are safe in pediatric patients. This review presents a management algorithm based on 49 cases from three centers, detailing pre-operative, intra-operative, and post-operative care.
Area of Science:
- Pediatric Surgery
- Thoracic Surgery
- Respiratory Medicine
Background:
- Tracheal resection in children is an infrequent procedure.
- Surgeons often rely on outdated historical data for complex tracheal resections.
- Technological and clinical advancements necessitate updated surgical approaches.
Purpose of the Study:
- To review the safety and efficacy of complex tracheal resections in pediatric patients.
- To present a comprehensive management algorithm for complex tracheal resections.
- To consolidate experience from three reference centers.
Main Methods:
- Retrospective review of 49 pediatric patients undergoing complex tracheal resection (30-50% length).
- Analysis of pre-operative evaluations, surgical approaches, and intra-operative oxygenation.
- Detailed examination of post-operative care and management strategies.
Main Results:
- Complex tracheal resections are safe and feasible in children with appropriate management.
- The study involved 49 pediatric patients across three specialized centers.
- A detailed management algorithm was developed based on collective experience.
Conclusions:
- Complex tracheal resections can be safely performed in pediatric patients.
- A structured management algorithm improves outcomes for tracheal resection surgery.
- Evidence-based protocols are crucial for advancing pediatric thoracic surgery.
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