Novel Suture Technique for Slide Tracheoplasty for the Treatment of Long-Segment Tracheal Stenosis

Long segment tracheal stenosis is a rare, life-threatening condition. Slide tracheoplasty is the surgical treatment of choice but is associated with significant morbidity and mortality. We examined our institutional outcomes utilizing a running, everting horizontal mattress suture technique. From August 2012 to January 2019, 7 infants and children underwent slide tracheoplasty with a single surgeon utilizing a running, everting horizontal mattress suture technique. Demographics and patient clinical data were obtained through chart review, and a retrospective analysis was performed. Median age was 7 months (range, 4 days – 19 months) and median weight was 5.5 kilograms (range, 2.8 – 9.4). All patients underwent slide tracheoplasty using a running, everting horizontal mattress suture technique. One patient died on post-operative day 45 of multisystem organ failure, unrelated to his patent airway. Length of post-operative ventilation in survivors was 7 days (range, 0 – 20 days). Average follow-up was 3 years. There were no instances of significant postoperative airway stenosis, anastomotic leak, granulation tissue formation, or figure-of eight deformity. A running, everting horizontal mattress suture technique is safe and efficacious for slide tracheoplasty, prevents figure-of-eight deformity, and may decrease the incidence of tracheal stenosis, airway granulation tissue formation, and anastomotic leak.