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Article: Management of symptomatic congenital tracheal stenosis in neonates and infants by slide tracheoplasty: A 7-year single institution experience

TitleManagement of symptomatic congenital tracheal stenosis in neonates and infants by slide tracheoplasty: A 7-year single institution experience
Authors
KeywordsInfant
Tracheal stenosis
Tracheal surgery
Issue Date2010
PublisherElsevier BV. The Journal's web site is located at http://www.elsevier.com/locate/ejcts
Citation
European Journal Of Cardio-Thoracic Surgery, 2010, v. 38 n. 5, p. 609-614 How to Cite?
AbstractObjective: Congenital tracheal stenosis (CTS) is rare. When it presents early in life, its management can be challenging. Of the surgical techniques that have been devised to correct long-segment CTS, slide tracheoplasty (ST) appears to be superior. We present our 7-year-experience of ST for the treatment of symptomatic CTS in neonates and infants. Methods: The hospital records of all 14 neonates and infants who underwent ST between 2001 and 2008 at our hospital were retrieved. Patient characteristics, trachea morphology, co-existing anomalies, operative procedures, techniques, outcomes and clinical courses were reviewed. Results: Patients underwent ST at age 4 days to 22 months (median: 2.4 months). Five (36%) required intermittent ventilator support prior to surgery. All ST was done under cardiopulmonary bypass. The associated cardiovascular anomalies in 10 infants (71%) were also corrected at the same operation. All survived the initial surgical procedures. The in-hospital mortality for the group was 14.3%. The median periods of postoperative intensive care unit and hospital stay of the 12 children, who were successfully extubated within 7 postoperative days, were 9 days (range: 6-28 days) and 28 days (range: 14-375 days), respectively. Follow-up of all 12 midterm survivors was complete, ranging from 5 months to 5.6 years (median: 40 months). A total of four patients had been found to have tracheobronchial malacia postoperatively and were managed with stenting. Of the remaining 10 survivors who had no residual or recurrent airway problems, and no cardiovascular residuum or sequela, two had gross developmental delay. Conclusions: In the management of symptomatic infants with CTS, our limited experience suggests that meticulously performed ST together with vigilant pre- and postoperative care can provide satisfactory short and midterm solution to the airway problem. Some incidental residual clinical problems appear to be unavoidable. © 2010 European Association for Cardio-Thoracic Surgery.
Persistent Identifierhttp://hdl.handle.net/10722/129331
ISSN
2015 Impact Factor: 2.803
2015 SCImago Journal Rankings: 1.568
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorLi, Xen_HK
dc.contributor.authorCheng, LCen_HK
dc.contributor.authorCheung, YFen_HK
dc.contributor.authorLun, KSen_HK
dc.contributor.authorChau, KTen_HK
dc.contributor.authorChiu, SWen_HK
dc.date.accessioned2010-12-23T08:35:23Z-
dc.date.available2010-12-23T08:35:23Z-
dc.date.issued2010en_HK
dc.identifier.citationEuropean Journal Of Cardio-Thoracic Surgery, 2010, v. 38 n. 5, p. 609-614en_HK
dc.identifier.issn1010-7940en_HK
dc.identifier.urihttp://hdl.handle.net/10722/129331-
dc.description.abstractObjective: Congenital tracheal stenosis (CTS) is rare. When it presents early in life, its management can be challenging. Of the surgical techniques that have been devised to correct long-segment CTS, slide tracheoplasty (ST) appears to be superior. We present our 7-year-experience of ST for the treatment of symptomatic CTS in neonates and infants. Methods: The hospital records of all 14 neonates and infants who underwent ST between 2001 and 2008 at our hospital were retrieved. Patient characteristics, trachea morphology, co-existing anomalies, operative procedures, techniques, outcomes and clinical courses were reviewed. Results: Patients underwent ST at age 4 days to 22 months (median: 2.4 months). Five (36%) required intermittent ventilator support prior to surgery. All ST was done under cardiopulmonary bypass. The associated cardiovascular anomalies in 10 infants (71%) were also corrected at the same operation. All survived the initial surgical procedures. The in-hospital mortality for the group was 14.3%. The median periods of postoperative intensive care unit and hospital stay of the 12 children, who were successfully extubated within 7 postoperative days, were 9 days (range: 6-28 days) and 28 days (range: 14-375 days), respectively. Follow-up of all 12 midterm survivors was complete, ranging from 5 months to 5.6 years (median: 40 months). A total of four patients had been found to have tracheobronchial malacia postoperatively and were managed with stenting. Of the remaining 10 survivors who had no residual or recurrent airway problems, and no cardiovascular residuum or sequela, two had gross developmental delay. Conclusions: In the management of symptomatic infants with CTS, our limited experience suggests that meticulously performed ST together with vigilant pre- and postoperative care can provide satisfactory short and midterm solution to the airway problem. Some incidental residual clinical problems appear to be unavoidable. © 2010 European Association for Cardio-Thoracic Surgery.en_HK
dc.languageengen_US
dc.publisherElsevier BV. The Journal's web site is located at http://www.elsevier.com/locate/ejctsen_HK
dc.relation.ispartofEuropean Journal of Cardio-thoracic Surgeryen_HK
dc.subjectInfanten_HK
dc.subjectTracheal stenosisen_HK
dc.subjectTracheal surgeryen_HK
dc.titleManagement of symptomatic congenital tracheal stenosis in neonates and infants by slide tracheoplasty: A 7-year single institution experienceen_HK
dc.typeArticleen_HK
dc.identifier.emailLi, X: lixin08@hku.hken_HK
dc.identifier.emailCheung, YF: xfcheung@hku.hken_HK
dc.identifier.authorityLi, X=rp00266en_HK
dc.identifier.authorityCheung, YF=rp00382en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1016/j.ejcts.2010.03.011en_HK
dc.identifier.pmid20417113-
dc.identifier.scopuseid_2-s2.0-77957905062en_HK
dc.identifier.hkuros183618en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-77957905062&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume38en_HK
dc.identifier.issue5en_HK
dc.identifier.spage609en_HK
dc.identifier.epage614en_HK
dc.identifier.eissn1873-734X-
dc.identifier.isiWOS:000284751100017-
dc.publisher.placeNetherlandsen_HK
dc.identifier.scopusauthoridLi, X=36068374600en_HK
dc.identifier.scopusauthoridCheng, LC=9533935800en_HK
dc.identifier.scopusauthoridCheung, YF=7202111067en_HK
dc.identifier.scopusauthoridLun, KS=8363663600en_HK
dc.identifier.scopusauthoridChau, KT=35975776800en_HK
dc.identifier.scopusauthoridChiu, SW=12788356600en_HK
dc.identifier.citeulike7083620-

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