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Revision thoracic slide tracheoplasty: Outcomes following unsuccessful tracheal reconstruction
Author(s) -
Sidell Douglas R.,
Hart Catherine K.,
Tabangin Meredith E.,
Bryant Roosevelt,
Rutter Michael J.,
Manning Peter B.,
MeinzenDerr Jareen,
Balakrishnan Karthik,
Yang Christina,
Alarcon Alessandro
Publication year - 2018
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.27145
Subject(s) - medicine , surgery , retrospective cohort study , cardiothoracic surgery , airway , tracheal stenosis , cardiopulmonary bypass , anesthesia
Objectives/Hypothesis Over the past decade, thoracic slide tracheoplasty (TST) has become the principal operation in the management of congenital tracheal stenosis. The purpose of this report was to describe our experience with revision TST following unsuccessful prior tracheal reconstruction. Study Design Retrospective analysis at an academic children's hospital. Methods Patients undergoing TST on cardiopulmonary bypass between January 2005 and May 2014 were reviewed. Patients with a history of prior airway surgery were extracted for further analysis. Preoperative patient variables and postoperative outcomes were evaluated and compared between patients undergoing revision slide tracheoplasty (RTST) and a control group of 26 matched patients undergoing primary surgery TST. Results Twenty‐six revision patients (25 referrals, one primary patient) of 162 patients reviewed over the study period met inclusion criteria. Twenty‐three patients had a history of complete tracheal rings, and three patients had cartilaginous deficiency. A total of 41 airway reconstruction procedures had been performed prior to RTST. When compared to primary TST, patients undergoing RTST required fewer cardiac procedures intraoperatively, and fewer mean ventilator hours ( P = .01) postoperatively. There was no significant difference in the median length of stay, requirement of >48 hours ventilation, or postoperative complications between groups. There was one nonsurgical postoperative mortality following RTST. Conclusions Despite some differences in the postoperative management when compared to nonrevision cases, revision TST can be successfully performed after prior tracheal reconstruction with good postoperative outcomes. Level of Evidence 4. Laryngoscope , 128:2181–2186, 2018