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Application of slide tracheoplasty in children with congenital tracheal stenosis

Published online by Cambridge University Press:  22 August 2025

Zhangwei Wang Open the ORCID record for Zhangwei Wang [Opens in a new window] ,
Honghao Fu  and
Shoujun Li
Zhangwei Wang
Affiliation:
Department of Cardiovascular Surgery, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center for Cardiovascular Diseases, Fuwai Hospital, Beijing, China
Honghao Fu
Affiliation:
Department of Cardiovascular Surgery, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center for Cardiovascular Diseases, Fuwai Hospital, Beijing, China
Shoujun Li*
Affiliation:
Department of Cardiovascular Surgery, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center for Cardiovascular Diseases, Fuwai Hospital, Beijing, China
*
Corresponding author: Shoujun Li; Email: beijing348@qq.com
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Abstract

Over the past two decades, there have been encouraging achievements in the surgical treatment of children with congenital tracheal stenosis. Slide tracheoplasty has become the standard surgical procedure for the correction of long-segment congenital tracheal stenosis with abnormal bronchial morphology in many medical centres around the world. Identification of the shape and degree of tracheal stenosis before operation is helpful to develop a better surgical strategy. Flexible application of slide tracheoplasty can effectively correct different types of congenital tracheal stenosis. Cardiopulmonary bypass and intraoperative fiberoptic bronchoscopy are helpful to improve the efficiency of surgery. Postoperative multidisciplinary cooperative management can improve the prognosis of children. Biodegradable scaffolds, tissue-engineered trachea, and 3D printing technology are based on a completely different perspective from traditional medicine. The initial attempts in the biomedical field provide a new idea for the treatment of congenital tracheal stenosis. This article reviews the classification, past and current situation, advantages, surgical indications, surgical techniques, prognosis, related risk factors, and prospects of slide tracheoplasty in the treatment of congenital tracheal stenosis in children.

Keywords

Congenital tracheal stenosisslide tracheoplastyprognosisprospect

Information

Type
Review
Information
Cardiology in the Young , Volume 35 , Issue 9 , September 2025 , pp. 1773 - 1781
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Copyright
© The Author(s), 2025. Published by Cambridge University Press

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Footnotes

*

Zhangwei Wang and Honghao Fu contributed equally to this work.

References

Cantrell, JR, Guild, HG. Congenital stenosis of the trachea. Am J Surg 1964; 108: 297–305.CrossRefGoogle ScholarPubMed
Du, Zhou, Jinlong, Liu, Jinfen, Liu. Progress on diagnosis and treatment of congenital tracheal stenosis. Chin J Clin Thorac Cardiovasc Surg 2016; 23: 178–182.Google Scholar
Benjamin, B, Pitkin, J, Cohen, D. Congenital tracheal stenosis. Ann Otol Rhinol Laryngol 1981; 90: 364–371.CrossRefGoogle ScholarPubMed
Loeff, DS, Filler, RM, Vinograd, I, et al. Congenital tracheal stenosis: a review of 22 patients from 1965 to 1987. J Pediatr Surg 1988; 23: 744–748.CrossRefGoogle ScholarPubMed
Chen, SJ, Wu, ET, Wang, CC, Chou, HW, Chen, YS, Huang, SC. Excessive tracheal length in patients with congenital tracheal stenosis. Ann Thorac Surg 2019; 108: 138–145.CrossRefGoogle ScholarPubMed
Herrera, P, Caldarone, C, Forte, V, et al. The current state of congenital tracheal stenosis. Pediatr Surg Int 2007; 23: 1033–1044.CrossRefGoogle ScholarPubMed
Maltezeanu, A, Aldriweesh, B, Chan, CY, et al. Slide tracheoplasty for congenital tracheal stenosis: a systematic review. Int J Pediatr Otorhinolaryngol 2024; 182: 111993.CrossRefGoogle ScholarPubMed
Anton-Pacheco, JL, Cano, I, Garcia, A, Martinez, A, Cuadros, J, Berchi, FJ. Patterns of management of congenital tracheal stenosis. J Pediatr Surg 2003; 38: 1452–1458.CrossRefGoogle ScholarPubMed
Speggiorin, S, Torre, M, Roebuck, DJ, Mclaren, CA, Elliott, MJ. A new morphologic classification of congenital tracheobronchial stenosis. Ann Thorac Surg 2012; 93: 958–961.CrossRefGoogle ScholarPubMed
Du, XW, Wang, PH, Wang, H, et al. Tracheoplasty should be proactively considered in the surgical strategy for treating the ring-sling complex. J Thorac Cardiovasc Surg 2025; 169: 375–384.CrossRefGoogle ScholarPubMed
Anand, VK, Alemar, G, Warren, ET. Surgical considerations in tracheal stenosis. Laryngoscope 1992; 102: 237–243.CrossRefGoogle ScholarPubMed
Myer, CR, O’Connor, DM, Cotton, RT. Proposed grading system for subglottic stenosis based on endotracheal tube sizes. Ann Otol Rhinol Laryngol 1994; 103: 319–323.CrossRefGoogle ScholarPubMed
Freitag, L, Ernst, A, Unger, M, Kovitz, K, Marquette, CH. A proposed classification system of central airway stenosis. Eur Respir J 2007; 30: 7–12.CrossRefGoogle ScholarPubMed
Harrison, MR, Heldt, GP, Brasch, RC, de Lorimier, AA, Gregory, GA. Resection of distal tracheal stenosis in a baby with agenesis of the lung. J Pediatr Surg 1980; 15: 938–943.CrossRefGoogle Scholar
Grillo, HC, Zannini, P. Management of obstructive tracheal disease in children. J Pediatr Surg 1984; 19: 414–416.CrossRefGoogle ScholarPubMed
Mansfield, PB. Tracheal resection in infancy. J Pediatr Surg 1980; 15: 79–81.CrossRefGoogle ScholarPubMed
Lobe, TE, Hayden, CK, Nicolas, D, Richardson, CJ. Successful management of congenital tracheal stenosis in infancy. J Pediatr Surg 1987; 22: 1137–1142.CrossRefGoogle ScholarPubMed
Tsang, V, Murday, A, Gillbe, C, Goldstraw, P. Slide tracheoplasty for congenital funnel-shaped tracheal stenosis. Ann Thorac Surg 1989; 48: 632–635.CrossRefGoogle ScholarPubMed
Grillo, HC. Slide tracheoplasty for long-segment congenital tracheal stenosis. Ann Thorac Surg 1994; 58: 613–619.CrossRefGoogle ScholarPubMed
Brazdil, J, Tlaskal, T, Vojtovic, P, Pohunek, P, Cihar, M. Slide plasty of trachea and right main bronchus in a newborn. Ann Thorac Surg 2008; 85: 1096–1097.CrossRefGoogle ScholarPubMed
Toma, M, Kamagata, S, Hirobe, S, et al. Modified slide tracheoplasty for congenital tracheal stenosis. J Pediatr Surg 2009; 44: 2019–2022.CrossRefGoogle ScholarPubMed
Huang, SC, Wu, ET, Wang, CC, et al. Repair of complex tracheobronchial stenosis with left pulmonary artery sling and bridging bronchus. Ann Thorac Surg 2010; 90: 1379–1381.CrossRefGoogle ScholarPubMed
Wang, S, Zhang, H, Zhu, L, Zhen, J, Liu, J, Xu, Z. Surgical management of congenital tracheal stenosis associated with tracheal bronchus and congenital heart disease. Eur J Cardiothorac Surg 2016; 49: 1201–1206.CrossRefGoogle ScholarPubMed
Chen, H, Shi, G, Zhu, L, Wang, S, Lu, Z, Xu, Z. Intermediate-term outcomes of slide tracheoplasty in pediatric patients with ring-sling complex. Ann Thorac Surg 2020; 109: 820–827.CrossRefGoogle ScholarPubMed
Speggiorin, S, Gilbert, TW, Broadhead, M, Roebuck, DJ, Mclaren, CA, Elliott, MJ. Do tracheas grow after slide tracheoplasty? Ann Thorac Surg 2012; 93: 1083–1086.CrossRefGoogle ScholarPubMed
Wilcox, LJ, Schweiger, C, Hart, CK, de Alarcon, A, Peddireddy, NS, Rutter, MJ. Growth and management of repaired complete tracheal rings after slide tracheoplasty. Otolaryngol Head Neck Surg 2019; 161: 164–170.CrossRefGoogle ScholarPubMed
Chen, L, Zhu, L, Wang, H, et al. Surgical management strategy of slide tracheoplasty for infants with congenital tracheal stenosis. J Thorac Cardiovasc Surg 2022; 163: 2218–2228.CrossRefGoogle ScholarPubMed
Wilcox, LJ, Hart, CK, de Alarcon, A, et al. Unrepaired complete tracheal rings: natural history and management considerations. Otolaryngol Head Neck Surg 2018; 158: 729–735.CrossRefGoogle ScholarPubMed
Rutter, MJ, Cotton, RT, Azizkhan, RG, Manning, PB. Slide tracheoplasty for the management of complete tracheal rings. J Pediatr Surg 2003; 38: 928–934.CrossRefGoogle ScholarPubMed
Butler, CR, Speggiorin, S, Rijnberg, FM, et al. Outcomes of slide tracheoplasty in 101 children: a 17-year single-center experience. J Thorac Cardiovasc Surg 2014; 147: 1783–1789.CrossRefGoogle ScholarPubMed
Maeda, M, Grillo, HC. Effect of tension on tracheal growth after resection and anastomosis in puppies. J Thorac Cardiovasc Surg 1973; 65: 658–668.CrossRefGoogle ScholarPubMed
Dayan, SH, Dunham, ME, Backer, CL, Mavroudis, C, Holinger, LD. Slide tracheoplasty in the management of congenital tracheal stenosis. Ann Otol Rhinol Laryngol 1997; 106: 914–919.CrossRefGoogle ScholarPubMed
Elliott, M, Roebuck, D, Noctor, C, et al. The management of congenital tracheal stenosis. Int J Pediatr Otorhinolaryngol 2003; 67: S183–S192.CrossRefGoogle ScholarPubMed
Cheng, W, Manson, DE, Forte, V, et al. The role of conservative management in congenital tracheal stenosis: an evidence-based long-term follow-up study. J Pediatr Surg 2006; 41: 1203–1207.CrossRefGoogle ScholarPubMed
Huang, SC, Wu, ET, Wang, CC, et al. Surgical management of pulmonary artery sling: trachea diameter and outcomes with or without tracheoplasty. Pediatr Pulmonol 2012; 47: 903–908.CrossRefGoogle ScholarPubMed
Mei, Dongyu. Surgical Management of Congenial Heart Disease associated with Congenial Tracheal Stenosis. Degree of Master, Shanghai Jiao Tong University, 2016.Google Scholar
Harada, A, Shimojima, N, Shimotakahara, A, et al. Surgical indication for congenital tracheal stenosis complicated by pulmonary artery sling. J Thorac Dis 2019; 11: 5474–5479.CrossRefGoogle ScholarPubMed
Hong, X, Zhou, G, Liu, Y, Liu, Y, Wang, H, Feng, Z. Management of pulmonary artery sling with tracheal stenosis: lpa re-implantation without tracheoplasty. Int J Clin Exp Med 2015; 8: 2741–2747.Google ScholarPubMed
Song, X, Lu, Z, Zhu, L, Du, X, Wang, S, Xu, Z. Morphologic analysis of congenital heart disease with anomalous tracheobronchial arborization. Ann Thorac Surg 2020; 110: 1387–1395.CrossRefGoogle ScholarPubMed
Yokoi, A. Congenital tracheal stenosis: what should we look at for successful tracheoplasty? Transl Pediatr 2018; 7: 229–232.CrossRefGoogle Scholar
Manning, PB, Rutter, MJ, Border, WL. Slide tracheoplasty in infants and children: risk factors for prolonged postoperative ventilatory support. Ann Thorac Surg 2008; 85: 1187–1192.CrossRefGoogle ScholarPubMed
Manning, PB, Rutter, MJ, Lisec, A, Gupta, R, Marino, BS. One slide fits all: the versatility of slide tracheoplasty with cardiopulmonary bypass support for airway reconstruction in children. J Thorac Cardiovasc Surg 2011; 141: 155–161.CrossRefGoogle ScholarPubMed
Mainwaring, RD, Shillingford, M, Davies, R, et al. Surgical reconstruction of tracheal stenosis in conjunction with congenital heart defects. Ann Thorac Surg 2012; 93: 1266–1273.CrossRefGoogle ScholarPubMed
Arcieri, L, Pak, V, Poli, V, et al. Tracheal surgery in children: outcome of a 12-year survey. Interact Cardiovasc Thorac Surg 2018; 26: 660–666.CrossRefGoogle ScholarPubMed
Wen, Wanyu, Du, Xinwei, Wang, Shunmin, Xu, Zhiwei, Lu, Zhaohui Morphologic improvements of trachea of children with congenital tracheal stenosis after slide tracheoplasty. Chin J Thorac Cardiovasc Surg 2022; 38: 402–408.Google Scholar
Chen, Y, Wen, W, Du, X, et al. Retrospective analysis of factors contributing to poor prognosis among 271 pediatric patients with tracheal stenosis treated with slide tracheoplasty. J Thorac Cardiovasc Surg 2024; 170: 36–45.e3.CrossRefGoogle ScholarPubMed
Liu, Y, He, Q, Dou, Z, Ma, K, Chen, W, Li, S. Management strategies for congenital heart disease comorbid with airway anomalies in children. J Pediatr 2024; 264: 113741.CrossRefGoogle ScholarPubMed
Beeman, A, Ramaswamy, M, Thiruchelvam, T, et al. Slide tracheoplasty in long segment tracheobronchial stenosis. Ann Thorac Surg 2024; 120: 355–364.CrossRefGoogle ScholarPubMed
Anton-Pacheco, JL. Tracheobronchial stents in children. Semin Pediatr Surg 2016; 25: 179–185.CrossRefGoogle ScholarPubMed
Anton-Pacheco, JL, Luna, C, Garcia, E, et al. Initial experience with a new biodegradable airway stent in children: is this the stent we were waiting for? Pediatr Pulmonol 2016; 51: 607–612.CrossRefGoogle ScholarPubMed
Jungebluth, P, Alici, E, Baiguera, S, et al. Tracheobronchial transplantation with a stem-cell-seeded bioartificial nanocomposite: a proof-of-concept study. Lancet 2011; 378: 1997–2004.CrossRefGoogle ScholarPubMed
Wentao, Zhang. 3D-printed trachea gives baby a second chance at life. World Science 2013; 09: 46–47.Google Scholar