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Tracheoplasty with pericardial patch for extensive tracheal stenosis in infants and children
Insights
Pericardial patch tracheoplasty using median sternotomy is a safe and effective surgical treatment for long tracheal stenosis in infants. Most infants achieve asymptomatic recovery without the need for prolonged stenting.
Area of Science:
- Pediatric Surgery
- Thoracic Surgery
- Cardiovascular Surgery
Background:
- Tracheal stenosis in infants presents a significant surgical challenge.
- Surgical repair often requires complex reconstructive techniques.
- Median sternotomy offers wide access to the trachea.
Observation:
- Five infants with long tracheal stenosis underwent pericardial patch tracheoplasty.
- The surgical approach utilized was median sternotomy with extracorporeal circulation.
- Four cases involved complete tracheal rings; one had associated trauma from resuscitation.
Findings:
- All patients, except the one with trauma requiring prolonged stenting, were asymptomatic postoperatively.
- The longest follow-up period was 22 months.
- No deaths or postoperative infections were reported.
Implications:
- Median sternotomy is an effective surgical approach for tracheal reconstruction.
- Autogenous pericardium serves as a beneficial graft material.
- Prolonged tracheal stenting is generally not required for most infants following this procedure.
Abstract:
Five infants with long tracheal stenosis were operated upon by means of a pericardial patch tracheoplasty. The approach was through a median sternotomy with extracorporeal circulation for respiratory support. In four, the obstruction was due to complete rings; in the other, there was an associated tracheal trauma which had occurred during resuscitation. This patient requires prolonged stenting with a tracheostomy tube. All others are asymptomatic postoperatively, with the longest follow-up being 22 months. There were no deaths or infections. We conclude from this experience that median sternotomy provides an excellent approach to the trachea, that autogenous pericardium is advantageous, and that there is no need for prolonged tracheal stenting in most patients.