Slide tracheoplasty

1. Slide Tracheoplasty
Chief Chin-Su Liu

2. History
• A 2-year-old girl
• Exertional dyspnea was noted for one year
• Dyspnea for 1 month after an episode of
common cold
• Referred from China to TVGH pediatric service
(Dr. Song)

3. Chest CT and 3-D CT
• A 3cm segmental stenosis of
lower trachea (diameter about 3.3x2.6 mm) and right main
bronchus.
• Pulmonary sling (left PA sling )

4. Peri-Operation course
• Sternotomy and reimplantation of LPA under
bypass (by CVS Dr., reimplantation took 30
minutes)
• Slide tracheoplasty (by Peds Dr., took 1 hour)
• Then change to ECMO to PICU
• Remove ECMO 2 days later
• Check bronchosopy 1 day after ECMO weaning
and remove endotracheal tube simutaneously
• Recheck bronchoscopy one week after operation
• Discharged 8 days after operation

5. Brief Discussions
 Five main open surgical approaches for congenital
tracheal stenosis
 Resection with end-to-end anastomosis
 Enlargement patch tracheoplasties
 Tracheal autograft technique
 Slide tracheoplasty
 tracheoplasty with cadaveric tracheal homografts
 Balloon dilatation with self-expandable metallic airway
stents (SEMAS): can only be used for recurrent
inoperable tracheal stenosis as a last-chance treatment,
after open surgery failed.
Pediatric Airway Surgery, editor: Philippe Monnier, Springer, 2011