ESOPHAGEAL TRACHEOBRONCHOPLASTY FOR DISEASES OF THE CENTRAL AIRWAY

Three infants with congenital tracheal stenosis and three adults with various diseases of the central airway underwent esophageal tracheobro nchoplasty to repair long-segment stenoses and defects, The primary op erative goal was enlargement of the stenosis (n = 4), repair of the de fect (n = 1), or both (n = 1), Cardiopulmonary support was required in two cases, All three infants were operated on for generalized congeni tal tracheal stenoses, There was one postoperative death on the fifth day, Another infant died of pneumonia 3 months after operation, Trache al patency was excellent in two infants, One infant is well without sy mptoms 6 years after the operation, although balloon dilation was requ ired three times during the first postoperative year, In the three adu lt patients, the primary diseases were congenital tracheal stenosis, i atrogenic injury associated with relapsing polychondritis, and maligna nt mediastinal tumor involving the trachea, All lesions involved both the trachea and main stem bronchi. Postoperative airway patency was ex cellent in all three adults, although expandable metallic stents had t o he inserted in one patient. postoperative pulmonary function Ras imp roved, particularly forced expiratory volume in I second and peak expi ratory how rate, Although the postoperative mortality rate was still h igh, especially among the infants, and prolonged postoperative ventila tory support was required for five of the sis patients, long-term pate ncy and postoperative pulmonary functional improvement are encouraging .