Slide Tracheoplasty for Severe Congenital Long Segment
Tracheal Stenosis in Infants : Surgical and Anesthetic
Management
MONGKOL LAOHAPANSANG, M.D.*, TEERAW IT PHANCHAIPETCH,M.D.**,
SUNEERA T KONGSA YREEPONG, M.D.***, KITTIRAT UNGKANONT, M.D.****
Affiliation : * Section of Pediatric Surgery,
** Section of Cardiothoracic Surgery, Department of Surgery,
*** Department of Anesthesiology,
**** Department of Otorhinolaryngology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700,
Thailand.
AbstractCongenital long segment tracheal stenosis is the rare occurrence of an intrinsic narrowing
of the trachea due to a complete cartilagenous ring. It is difficult to manage and can be life threaten
ing especially when these patients who are usually neonates or infants have the pathological pattern
of a long segment and have to come for surgical correction. Despite many technical reports on how
to correct this anormaly, currently, the technique of "slide tracheoplasty" is claimed to be the most
successful with the good immediate and long-term outcomes. But because of the rare and life threa
tening disease, so we were encouraged and write this report about the disease and its management.
These are the case series reports of 4 infants with a history and diagnosis of severe long
segment congenital tracheal stenosis who needed a difinite surgical repair. The authors decided to
use the surgical technique of "slide tracheoplasty" with successful outcome. In. two of the cases,
patients needed cardioplumonary bypass support during the surgical repair. All of these patients
did well after the operation except one patient with a history of congenital heart disease (tetralogy of
Fallot) who needed an emergency surgical repair and was reoperated upon with pericardia! patch. In
this reports the authors did not find any benefit from tracheostomy. Also, details of surgical and anes
thetic procedure were discussed with the conclusion that the surgical technique of slide tracheoplasty
should be the surgical of choice for the management of congenital long segment tracheal stenosis.
Keywords : Long Segment Tracheal Stenosis, Anesthesia, Surgery, Slide Tracheoplasty
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