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The Annals of Thoracic Surgery, Vol 58, 613-619, Copyright © 1994 by The Society of Thoracic Surgeons
HC Grillo
Resection and reconstruction of long congenital tracheal stenosis often is
impossible or results in excessive anastomotic tension. Anterior
tracheoplasty using a patch of pericardium or cartilage may result in
granulation tissue needing repeated bronchoscopies, tracheostomy, and
stents and may produce recurrent stenosis. Tracheoplasty may be performed
by dividing the stenosis at midpoint, incising the proximal and distal
narrowed segments vertically on opposite anterior and posterior surfaces
and sliding these together. The stenotic segment is shortened by half, the
circumference doubled, and the lumenal cross- section quadrupled. Approach
is cervical or with partial sternotomy. Cardiopulmonary bypass is not
necessary. Four patients (ages: 3 months, 3 1/2 years, 19 years, and 19
years) were so treated for stenosis of 36% to 83% of tracheal length. Blood
supply was not impaired. Healing was excellent and complications were
minimal.
ARTICLES
Slide tracheoplasty for long-segment congenital tracheal stenosis
General Thoracic Surgical Unit, Massachusetts General Hospital, Boston 02114.
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