Treatment strategies in the management of severe complications following slide tracheoplasty in children
| Autor: | María Isabel Benavent, Carmen Luna, M Dolores Méndez, Victoria Ramos, Juan V Comas, María Luisa Osete López, Juan L. Antón-Pacheco |
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| Rok vydání: | 2014 |
| Předmět: |
Male
Pulmonary and Respiratory Medicine medicine.medical_specialty medicine.medical_treatment Preoperative care Postoperative Complications Bronchoscopy medicine Humans business.industry Infant Stent Retrospective cohort study General Medicine Left pulmonary artery Plastic Surgery Procedures Pulmonary artery sling medicine.disease Surgery Tracheal Stenosis Treatment Outcome Great vessels Child Preschool Female Stents Cardiology and Cardiovascular Medicine business Airway |
| Zdroj: | European Journal of Cardio-Thoracic Surgery. 46:280-285 |
| ISSN: | 1873-734X 1010-7940 |
| DOI: | 10.1093/ejcts/ezt617 |
| Popis: | OBJECTIVES: This study focuses on the different surgical and endoscopical treatment alternatives when dealing with severe complications after slide tracheoplasty (STP). METHODS: Retrospective study of patients with symptomatic congenital tracheal stenosis (CTS) admitted to a single institution, between January 1997 and January 2013, surgically treated by means of STP. The following variables were evaluated: demographics, preoperative tracheal stenosis characteristics, associated anomalies and outcome measures. RESULTS: Cohort included 14 patients (8 males and 6 females) with a mean age of 8.7 months when treated (range, 1–43 m). Eleven patients (78%) showed a long segment CTS (>30% of total tracheal length) and 9 (64%) had associated cardiac or great vessel anomalies (left pulmonary artery sling). Three patients (21%) showed severe postoperative complications that required significant airway reintervention: tracheal resection of a restenotic segment, laser division with balloon dilatation of a residual stenosis and placement of a biodegradable endotracheal stent in an extensive tracheal narrowing. All patients are in good clinical condition with a mean follow-up of 6.3 years (range, 2 months to 16 years). CONCLUSIONS: STP has become the procedure of choice when dealing with CTS. Although it shows clear advantages compared with other surgical techniques, severe and difficult to manage complications may occur. Surgeons involved in their treatment should be familiar with diverse surgical and endoscopical procedures. Biodegradable airway stenting is a new and promising technique when long and severe post-surgical tracheal stenosis is present. |
| Databáze: | OpenAIRE |
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