Outcomes of Slide Tracheoplasty in Children: A Single-center Experience.

BACKGROUND: Long-segment tracheal stenosis in children is a rare, life-threatening condition. Slide tracheoplasty has emerged as the preferred surgical technique, but outcome data from resource-limited settings remain limited. MATERIALS AND METHODS: A retrospective review was performed on children who underwent slide tracheoplasty at our institution between 2012 and 2025. Demographic details, etiology, associated anomalies, and outcomes were analyzed. RESULTS: Twenty-eight children underwent slide tracheoplasty, including 15 boys and 13 girls. The median age was 1 year (range: 3 months-13 years). Congenital tracheal stenosis was present in 18 children. Complete trachea was involved in 7 children and segmental trachea in 11 (upper in 1 and lower in 10). Ten children had acquired stenosis, all with prior intubation. Seven children had pure tracheal stenosis, while three children had associated large tracheoesophageal fistulae. Children with acquired stenosis were older (median age: 8.5 years) compared to those with congenital pathology. Associated comorbidities were common, particularly congenital heart disease, seen in 19 children. Eleven children had a tracheostomy at presentation. There were two postoperative deaths, both in the congenital group, related to persistent low cardiac output following associated cardiac surgery. No deaths were directly attributable to tracheal reconstruction. Adequate airway was achieved in all surviving children. Late airway interventions (laryngoplasty in two children and balloon dilatation in one) were required in three children, with all eventually achieving a stable airway. CONCLUSION: Slide tracheoplasty provides effective and durable airway reconstruction in children with long-segment tracheal stenosis. Despite associated cardiac anomalies, morbidity and mortality are low, and excellent airway outcomes can be achieved.