Management of long-segment tracheal stenosis: a continuing surgical challenge

Yazdanbakhsh et al. [1] report a surgical technique using autolo-gous pericardial patch and strips of costal cartilage for relieving severe tracheal stenosis. Over nearly two decades of experience, 21 patients were treated, with 3 (14%) suffering late postoperative mortality. Seven patients underwent bronchoscopic reinterven-tion and 8 underwent surgical intervention, including 3 sliding tra-cheoplasty and 5 patch and strip techniques. This paper presents good results with a detailed long-term follow-up. I believe it is worth a careful read for its appraisals of various tracheoplasty techniques. The patch and strip technique has benefits for both pericardial patch and costal cartilage. Pericardial patch is too flaccid and results in tracheomalacia after reconstruction, and costal cartilage is too rigid making it difficult to achieve air-tight anastomosis. Combining both materials can reconstruct an enlarged trache