Introduction

The slide tracheoplasty is a procedure used to treat long-segment tracheal stenosis. 

The trachea is a tube of c-shaped cartilage rings that carry air from the nose and mouth to the lungs. Cartlidge is a flexible and firm tissue that lets the trachea move and flex while breathing.

In long-segment tracheal stenosis, the cartilage rings become hard, inflexible, and O-shaped. These are called complete tracheal rings. Complete tracheal rings narrow the windpipe, which can cause breathing issues. 

The slide tracheoplasty procedure widens and rebuilds the trachea to improve breathing and support healthy growth.

Before the procedure, your child’s surgeon may organise tests and scans to check the trachea. 

The hospital will call you before your child’s procedure to let you know:

• what time you need to arrive
• when your child needs to stop eating and drinking
• whether it is a day procedure or whether they will stay overnight in the hospital.

Your child will have a general anaesthetic for the procedure. This means they will be asleep and will not feel any pain.

The slide tracheoplasty can take up to four hours, depending on: 

• how severe the complete tracheal rings are
• whether any other procedures are happening at the same time.

Generally, the steps for the slide tracheoplasty are:

1. the surgeon makes a cut in the neck or the chest, depending on where the complete tracheal rings are
2. the trachea is split into two parts – top and bottom
3. the top part of the trachea is cut down the back
4. the bottom part of the trachea is cut down the front
5. two parts are slid together and stitched to make the trachea wider and stronger.

Some children may need to be connected to a heart-lung bypass machine during the procedure to help pump blood and oxygen throughout their body. Your child’s surgeon will answer any questions about the heart-lung bypass machine.

After the procedure, it is normal for your child to have:

• grogginess and nausea after general anaesthetic
• some pain and discomfort
• slight bleeding at the surgery site
• noisy breathing
• a higher temperature than usual.

Your child may go to the paediatric intensive care unit (PICU) and be connected to a ventilator to help them breathe while the trachea heals.

After a few days of recovery, your child will have:

• regular chest physiotherapy to help them remove mucus until they can cough on their own
• bronchoscopies – a simple procedure that lets the doctor look at your child’s airways.

Your child will slowly stop using the ventilator. This may take a few days, depending on how they are recovering.

Once they have stopped using the ventilator, they will be moved to a ward for the rest of their recovery. 

Your child may need to have:

• a few more bronchoscopies to check their healing
• another small procedure under general anaesthetic to stretch out the trachea with a balloon.

Your child will be able to go home when the treatment team are happy with their recovery.

You will get training on how to manage your child’s slide tracheoplasty, and your child may be sent home with:

• a nebuliser to help with taking medication
• antibiotics to prevent infection.

Your child will need regular follow-up appointments with their doctor and bronchoscopies to check their trachea.