Abstract Objective To study the role of bronchoscopy in slide tracheoplasty. Methods A retrospective analysis was conducted on the diagnosis and treatment of four children with tracheal stenosis admitted to Hunan Provincial People's Hospital from 2017 to 2020. The role of bronchoscopy was summarized in the preoperative evaluation, intraoperative positioning and measurement, and postoperative wound evaluation and treatment during slide tracheoplasty. Results Bronchoscopy evaluation before slide tracheoplasty showed that 3 of the 4 children had complete trachea rings, 2 had pulmonary artery sling, and 2 had multiple stenosis. Slide tracheoplasty was performed in the hospital on 3 children, and the midpoint of the stenosis segment was judged under bronchoscopy, and the length of the stenosis segment was measured, which assisted in the resection of the stenosis segment of the trachea. The pathogens were identified by lavage after the surgery. One child who developed scar traction 9 months after slide tracheoplasty in another hospital was improved by interventional treatment under bronchoscopy. Mucosal changes were found under bronchoscopy in 2 children 4 days after surgery, and the treatment plan was adjusted. One month after surgery, 2 children had granulation hyperplasia, which was improved by cryotherapy under bronchoscopy. One child abandoned treatment due to anastomotic necrosis and died. Three survivors were followed up for over 6 months with good prognosis, but all had tracheobronchial malacia. Conclusions Bronchoscopy can be used for the management of slide tracheoplasty in children with tracheal stenosis, which is helpful to postoperative rehabilitation and follow-up.
Antón-Pacheco JL, Comas JV, Luna C, et al. Treatment strategies in the management of severe complications following slide tracheoplasty in children[J]. Eur J Cardiothorac Surg, 2014, 46(2): 280-285. PMID: 24446477. DOI: 10.1093/ejcts/ezt617.
Chiu PP, Kim PC. Prognostic factors in the surgical treatment of congenital tracheal stenosis: a multicenter analysis of the literature[J]. J Pediatr Surg, 2006, 41(1): 221-225; discussion 221-225. PMID: 16410137. DOI: 10.1016/j.jpedsurg.2005.10.043.
Porcedda G, Brambilla A, Favilli S, et al. Combined surgical and endoscopic approach for ring-sling complex[J]. Thorac Cardiovasc Surg, 2020, 68(1): 51-58. PMID: 30743276. DOI: 10.1055/s-0039-1678670.
Wilcox LJ, Schweiger C, Hart CK, et al. Growth and management of repaired complete tracheal rings after slide tracheoplasty[J]. Otolaryngol Head Neck Surg, 2019, 161(1): 164-170. PMID: 30961421. DOI: 10.1177/0194599819841893.
Tsugawa C, Nishijima E, Muraji T, et al. Tracheoplasty for long segment congenital tracheal stenosis: analysis of 29 patients over two decades[J]. J Pediatr Surg, 2003, 38(12): 1703-1706. PMID: 14666447. DOI: 10.1016/j.jpedsurg.2003.08.037.
Stephens EH, Eltayeb O, Mongé MC, et al. Pediatric tracheal surgery: a 25-year review of slide tracheoplasty and tracheal resection[J]. Ann Thorac Surg, 2020, 109(1): 148-153. PMID: 31400322. DOI: 10.1016/j.athoracsur.2019.06.042.