WOFAPS 2025 8th World Congress of Pediatric Surgery

Abdumanap Alkhasov, Sergey Ratnikov, Elena Komina, Sergey Kuzin, Shahriyar Suleimanov

National Medical Research Center for Children’s Health Federal state autonomous institution of the Russian Federation Ministry of Health, Moscow, Russia

Introduction: Congenital Tracheal Stenosis (CTS) with complete cartilaginous rings is a rare but potentially life-threatening condition in pediatric patient.

Materials and methods: from 2019 to 2025 22 children with CTS were treated in the surgical thoracic department. Age at the time of surgery - 1.5 months - 12 years. Weight 2980 g - 54 kg.

Results: 9 patients (40.9%) were admitted to the hospital on mechanical ventilation. According to CT data, the cross-sectional area of the trachea was 0.0065-0.12 cm2 (mean 0.052±0.036 cm2). The length of stenosis was 30-75% of the trachea length. Congenital defects of the great arteries and heart were detected in 11 patients. We used ECMO in 17cases and artificial circulation in 5. Circular resection of the trachea was performed in 1 case, sliding tracheoplasty - in 21. Congenital heart disease correction was performed simultaneously in 8 children: Duration of mechanical ventilation was 2 -5 days. Discharged from the hospital on - 16.3 ± 5.14 p / o day.

After surgery unilateral paresis of the vocal cord without respiratory failure was detected in 2 patients (9.1%), In 1 case (4.5%) we performed laser vaporization of tracheal granuloma. A good result was obtained in 20 (90.9%) patients. In all cases the lumen of the trachea increased from 1.5 to 2 times. According to CT data, the cross-sectional area of the trachea was 0.052 cm2 - 0.42 cm2 (average 0.213 ± 0.144 cm2). Two children died due to sepsis and multiple organ failure. These children were admitted to hospital on artificial ventilation due to aspiration pneumonia.

Conclusions: successful reconstructive operations on the trachea are possible with the use of artificial circulation. Sliding tracheoplasty allows increasing the tracheal lumen by 1.5 - 2 times. Artificial lung ventilation is a prognostic unfavorable factor in the outcome of treatment for CTS.