Morita Keiichi, Yokoi Akiko, Fukuzawa Hiroaki, Hisamatsu Chieko, Endo Kosuke, Okata Yuichi, Tamaki Akihiko, Mishima Yasuhiko, Oshima Yoshihiro, Maeda Kosaku
Department of Pediatric Surgery, Kobe Children's Hospital, 1-6-7 Minatojimaminamimachi, Chuo-ku, Kobe, 650-0047, Japan.
Department of Cardiovascular Surgery, Kobe Children's Hospital, Kobe, Japan.
Pediatr Surg Int. 2016 Sep;32(9):915-9. doi: 10.1007/s00383-016-3928-8. Epub 2016 Jul 25.
The aim of this study was to determine the appropriate surgical intervention strategies for congenital tracheal stenosis (CTS) associated with a tracheal bronchus based on the location of stenosis.
The medical records of 13 pediatric patients with CTS associated with a tracheal bronchus at a single institution between January 2006 and December 2015 were retrospectively reviewed.
Type 1: tracheal stenosis above the right upper lobe bronchus (RULB) (n = 1). One patient underwent slide tracheoplasty and was successfully extubated. Type 2: tracheal stenosis below the RULB (n = 7). Tracheal end-to-end anastomosis was performed before 2014, and one patient failed to extubate. Posterior-anterior slide tracheoplasty was performed since 2014, and all three patients were successfully extubated. Type 3: tracheal stenosis above the RULB to the carina (n = 5). One patient underwent posterior-anterior slide tracheoplasty and was successfully extubated. Two patients with left-right slide tracheoplasty and another two patients with tracheal end-to-end anastomosis for the stenosis below the RULB could not be extubated.
Tracheal end-to-end anastomosis or slide tracheoplasty can be selected for tracheal stenosis above the RULB according to the length of stenosis. Posterior-anterior slide tracheoplasty appears feasible for tracheal stenosis below the RULB or above the RULB to the carina.
本研究的目的是根据狭窄部位确定与气管支气管相关的先天性气管狭窄（CTS）的合适手术干预策略。
回顾性分析2006年1月至2015年12月期间在单一机构就诊的13例患有与气管支气管相关的CTS的儿科患者的病历。
1型：右上叶支气管（RULB）上方的气管狭窄（n = 1）。1例患者接受了滑动气管成形术并成功拔管。2型：RULB下方的气管狭窄（n = 7）。2014年前进行了气管端端吻合术，1例患者未能拔管。自2014年以来进行了前后滑动气管成形术，所有3例患者均成功拔管。3型：RULB上方至隆突的气管狭窄（n = 5）。1例患者接受了前后滑动气管成形术并成功拔管。2例接受左右滑动气管成形术的患者以及另外2例因RULB下方狭窄接受气管端端吻合术的患者未能拔管。
对于RULB上方的气管狭窄，可根据狭窄长度选择气管端端吻合术或滑动气管成形术。前后滑动气管成形术对于RULB下方或RULB上方至隆突的气管狭窄似乎可行。
