Slide Tracheoplasty in Long Segment Tracheobronchial Stenosis

Area of Science:

• Pediatric Surgery
• Thoracic Surgery
• Congenital Airway Malformations

Background:

• Long segmental congenital tracheal stenosis and tracheobronchial stenosis are rare airway anomalies.
• These conditions present with diverse branching patterns (arborizations).

Purpose of the Study:

• To analyze the clinical presentations and surgical outcomes of slide tracheoplasty.
• To evaluate outcomes in patients with long segmental congenital tracheal and tracheobronchial stenosis with variable arborizations.

Main Methods:

• Retrospective analysis of 210 patients undergoing slide tracheoplasty (March 1995-February 2023).
• Classification of preoperative airway morphology using the Great Ormond Street Hospital for Children system.
• Comparison of outcomes based on different airway arborizations.

Main Results:

• 40% of patients had abnormal airway arborization; tracheobronchial morphology was most common.
• Patients with trifurcation arborization showed higher mortality (23%) and stent requirements (35%).
• Early presentation with critical stenosis and need for ventilation/ECMO support was noted in carinal trifurcation cases.

Conclusions:

• Slide tracheoplasty is the established surgical approach for long segmental congenital tracheal and tracheobronchial stenosis.
• Preoperative assessment of tracheal arborization and stenosis extent is crucial for optimizing surgical strategy and outcomes.