Lipshutz G S, Jennings R W, Lopoo J B, Farmer D, Harrison M R, Albanese C T
Department of Surgery, University of California, San Francisco 94143-0570, USA.
J Pediatr Surg. 2000 Feb;35(2):259-61. doi: 10.1016/s0022-3468(00)90020-4.
BACKGROUND/PURPOSE: A variety of techniques have been used to manage pediatric congenital tracheal stenosis. The authors report the technique of slide tracheoplasty for a child with long congenital tracheal stenosis.
A 2-year-old male presented with a history of stridor with feeding. Bronchoscopy findings showed 50% stenosis from complete cartilaginous rings, extending from 2.5 cm below the vocal cords to 2 cm above the carina. Through a neck incision, the trachea was exposed from the cricoid to both bronchi and transected at the midpoint of the stenosis. The upper trachea was split anteriorly to the area of stenosis just below the cricoid. The lower trachea was split posteriorly in the midline. Posterior dissection allowed sliding and anastomosis of both tracheal segments while the lateral vascular supply was left intact. A brace was placed to maintain cervical flexion, and the patient underwent extubation in the operating room.
He recovered without complication and was dis charged on postoperative day 4.
Slide tracheoplasty offers several advantages for tracheal reconstruction because it is performed with the native tracheal tissues, can be accomplished through a transverse collar incision, and can repair long stenoses without significant tracheal shortening.
背景/目的：多种技术已被用于治疗小儿先天性气管狭窄。作者报告了一例患有长段先天性气管狭窄患儿的滑动气管成形术技术。
一名2岁男性患儿，有进食时喘鸣病史。支气管镜检查发现，由完整软骨环导致的50%狭窄，从声带下方2.5厘米延伸至隆突上方2厘米。通过颈部切口，暴露从环状软骨到双侧支气管的气管，并在狭窄中点处横断。将上段气管在环状软骨下方狭窄区域前方劈开。下段气管在中线后方劈开。通过后方分离使两段气管滑动并吻合，同时保留外侧血管供应。放置一个支架以保持颈部前屈，患者在手术室拔管。
他恢复良好，无并发症，术后第4天出院。
滑动气管成形术在气管重建方面有几个优点，因为它使用自体气管组织进行，可通过横向颈部切口完成，并且能够修复长段狭窄而无需显著缩短气管。
