Revision thoracic slide tracheoplasty

Outcomes following unsuccessful tracheal reconstruction

Douglas R. Sidell, Catherine K. Hart, Meredith E. Tabangin, Roosevelt Bryant, Michael J. Rutter, Peter B. Manning, Jareen Meinzen-Derr, Karthik Balakrishnan, Christina J. Yang, Alessandro de Alarcon

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

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.

Original languageEnglish (US)
JournalLaryngoscope
DOIs
StateAccepted/In press - Jan 1 2018

Fingerprint

Thorax
Mechanical Ventilators
Cardiopulmonary Bypass
Thoracic Surgery
Ventilation
Length of Stay
Referral and Consultation
Retrospective Studies
Control Groups
Mortality

Keywords

  • Airway (nonsleep)
  • Airway stenosis/reconstruction
  • Pediatric
  • Slide tracheoplasty
  • Trachea
  • Tracheal stenosis

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

Sidell, D. R., Hart, C. K., Tabangin, M. E., Bryant, R., Rutter, M. J., Manning, P. B., ... de Alarcon, A. (Accepted/In press). Revision thoracic slide tracheoplasty: Outcomes following unsuccessful tracheal reconstruction. Laryngoscope. https://doi.org/10.1002/lary.27145

Revision thoracic slide tracheoplasty : Outcomes following unsuccessful tracheal reconstruction. / Sidell, Douglas R.; Hart, Catherine K.; Tabangin, Meredith E.; Bryant, Roosevelt; Rutter, Michael J.; Manning, Peter B.; Meinzen-Derr, Jareen; Balakrishnan, Karthik; Yang, Christina J.; de Alarcon, Alessandro.

In: Laryngoscope, 01.01.2018.

Research output: Contribution to journalArticle

Sidell, DR, Hart, CK, Tabangin, ME, Bryant, R, Rutter, MJ, Manning, PB, Meinzen-Derr, J, Balakrishnan, K, Yang, CJ & de Alarcon, A 2018, 'Revision thoracic slide tracheoplasty: Outcomes following unsuccessful tracheal reconstruction', Laryngoscope. https://doi.org/10.1002/lary.27145
Sidell, Douglas R. ; Hart, Catherine K. ; Tabangin, Meredith E. ; Bryant, Roosevelt ; Rutter, Michael J. ; Manning, Peter B. ; Meinzen-Derr, Jareen ; Balakrishnan, Karthik ; Yang, Christina J. ; de Alarcon, Alessandro. / Revision thoracic slide tracheoplasty : Outcomes following unsuccessful tracheal reconstruction. In: Laryngoscope. 2018.
@article{89d4c3e38fb1476ba533fcf234fff10c,
title = "Revision thoracic slide tracheoplasty: Outcomes following unsuccessful tracheal reconstruction",
abstract = "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.",
keywords = "Airway (nonsleep), Airway stenosis/reconstruction, Pediatric, Slide tracheoplasty, Trachea, Tracheal stenosis",
author = "Sidell, {Douglas R.} and Hart, {Catherine K.} and Tabangin, {Meredith E.} and Roosevelt Bryant and Rutter, {Michael J.} and Manning, {Peter B.} and Jareen Meinzen-Derr and Karthik Balakrishnan and Yang, {Christina J.} and {de Alarcon}, Alessandro",
year = "2018",
month = "1",
day = "1",
doi = "10.1002/lary.27145",
language = "English (US)",
journal = "Laryngoscope",
issn = "0023-852X",
publisher = "John Wiley and Sons Inc.",

}

TY - JOUR

T1 - Revision thoracic slide tracheoplasty

T2 - Outcomes following unsuccessful tracheal reconstruction

AU - Sidell, Douglas R.

AU - Hart, Catherine K.

AU - Tabangin, Meredith E.

AU - Bryant, Roosevelt

AU - Rutter, Michael J.

AU - Manning, Peter B.

AU - Meinzen-Derr, Jareen

AU - Balakrishnan, Karthik

AU - Yang, Christina J.

AU - de Alarcon, Alessandro

PY - 2018/1/1

Y1 - 2018/1/1

N2 - 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.

AB - 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.

KW - Airway (nonsleep)

KW - Airway stenosis/reconstruction

KW - Pediatric

KW - Slide tracheoplasty

KW - Trachea

KW - Tracheal stenosis

UR - http://www.scopus.com/inward/record.url?scp=85046540938&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85046540938&partnerID=8YFLogxK

U2 - 10.1002/lary.27145

DO - 10.1002/lary.27145

M3 - Article

JO - Laryngoscope

JF - Laryngoscope

SN - 0023-852X

ER -