Rutter Michael J, Cotton Robin T, Azizkhan Richard G, Manning Peter B
Departments of Pediatric Otolaryngology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229-3039, USA.
J Pediatr Surg. 2003 Jun;38(6):928-34. doi: 10.1016/s0022-3468(03)00126-x.
BACKGROUND/PURPOSE: Although rare, complete tracheal rings are the most common cause of congenital tracheal stenosis. The last 2 decades have seen an evolution in management, with increasing awareness of the potential advantages of slide tracheoplasty.
Between March 2001 and August 2002, 11 children had complete tracheal rings corrected by slide tracheoplasty. Ages ranged from newborn to 15 years, and weight ranged from 1.8 to 57 kg. Length of stenosis ranged from 3 rings to virtually the whole length of the trachea. The most narrow point in the airway varied from less than 1.9 mm to 4.8 mm. Eight children had other congenital anomalies, severe in one child. Most children underwent repair on cardiopulmonary bypass.
Nine children are asymptomatic or minimally symptomatic, although 2 have endoscopic evidence of mild residual tracheal stenosis. One child, who had been unstable pre-operatively, died of multiple organ failure 7 weeks postoperatively. A second child required a tracheotomy for bronchomalacia at 6 months and died at 9 months with tracheotomy tube occlusion. Both children had adequate tracheal repairs. Complications have included lateral tracheal stenosis (the "Figure 8" trachea) and recurrent laryngeal nerve damage.
Our management of complete tracheal rings has evolved over the last decade, and slide tracheoplasty currently is our preferred surgical approach for tracheal stenosis regardless of the length of narrowing.
背景/目的：尽管完整气管环较为罕见，但却是先天性气管狭窄最常见的病因。在过去20年中，治疗方法不断演变，人们越来越意识到滑动气管成形术的潜在优势。
2001年3月至2002年8月期间，11例患有完整气管环的儿童通过滑动气管成形术进行了矫正。年龄从新生儿到15岁不等，体重从1.8千克到57千克不等。狭窄长度从3个气管环到几乎整个气管长度。气道最狭窄点从小于1.9毫米到4.8毫米不等。8名儿童伴有其他先天性异常，其中1名儿童异常严重。大多数儿童在体外循环下接受修复手术。
9名儿童无症状或症状轻微，尽管有2名儿童在内镜检查时有轻度残余气管狭窄的证据。1名术前情况不稳定的儿童术后7周死于多器官功能衰竭。另1名儿童在6个月时因支气管软化需要进行气管切开术，并在9个月时因气管切开管堵塞死亡。两名儿童的气管修复均充分。并发症包括气管侧壁狭窄（“8”字形气管）和喉返神经损伤。
在过去十年中，我们对完整气管环的治疗方法不断演变，目前滑动气管成形术是我们治疗气管狭窄的首选手术方法，无论狭窄长度如何。
