Surgical treatment of tracheal obstruction in children

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Abstract

47 infants and children with tracheobronchial obstruction requiring surgical treatment are reported. 10 had subglottic stenosis; 17 severe tracheomalacia; 19 intraluminal tracheal stenosis (in 2 of whom it was congenital); 12 granulation tissue or webs; 4 both tracheal stenosis and tracheal fistula; and 1 had a tear of the right main bronchus. The anterior cricoid splitting procedure for the management of severe acquired subglottic stenosis was performed in 10, in 2 of whom it failed and tracheostomy was required. Aortopexy was performed in 14 cases and pulmonary arteriopexy in 1. A rib cartilage graft and a prosthetic splint fabricated from Marlex mesh were applied in 2 cases after failed aortopexy. The 19 patients with tracheal stenosis were treated as follows: tracheal splitting with autologous free tibial periosteal graft was used in 2 infants; transbronchoscopic resection was successful in 12 children; wedge resection of the tracheal fistula and anterior anastomosis was done in 4; segmental tracheal resection with end-to-end anastomosis in 1; and suture of a bronchial tear was performed in 1. There was no operative mortality; 2 patients died; but the deaths were not directly related to surgery. In our experience, the surgical approach is both safe and expedient in relieving tracheal obstruction in most infants and children.

Original languageEnglish
Pages (from-to)329-333, 392
JournalHarefuah
Volume125
Issue number10
StatePublished - 15 Nov 1993
Externally publishedYes

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