Rossi ME, et al. - This observational study was conducted to evaluate the epidemiological aspects, surgical approach, morbidity, and mortality rates of subjects having tracheal stenosis requiring surgery. Researchers also assessed the evolution of surgical techniques over the last years. In 28 children, effective treatment of surgical tracheal stenosis was performed between 1990 and 2015. A better management of this rare and serious disease is possible because of the evolution of the surgical techniques.

Methods

• Experts conducted a retrospective observational study from 1990 to 2017 in a pediatric tertiary-care center on subjects who required surgery for tracheal stenosis.
• They evaluated clinical characteristics of patients, type of stenosis, type of surgery and follow-up.

Results

• Findings suggested that 28 children had tracheal stenosis, half of them had congenital stenosis (complete tracheal rings) and the other half had acquired stenosis (neoplasic or post intubation injury).
• As per the outcomes, 39.3% of these stenoses to be related to a vascular ring (61.5% in case of congenital stenosis).
• Surgery could be performed endoscopically or by an external approach, depending on the extent of the stenosis and its origin,.
• It was noted that enlargement tracheoplasty with an autograft (14.3%) was replaced by slide tracheoplasty with Cardio Pulmonary By-Pass (CPBP, 28.6%) displaying improved effects for the treatment of long segment tracheal stenosis, it involved more than 30% of the tracheal length (all were congenital in this study).
• Since the late 90's, slide tracheoplasty was being performed in this institution.
• Data suggested that 25% of children had experienced a resection and anastomosis of the trachea as they had a stenosis involving less than 30% of tracheal length.
• For membranous stenoses, endoscopic surgery was performed which were often seen following intubation or tracheotomy (32.1% of patients).