Abstract：
Surgical reconstruction of paediatric laryngotracheal stenosis (LTS) has only been developed over the last 30 years, but during that period great advances have been made, and the operation is now very much tailored to the needs of the individual patient. Closed (endoscopic) techniques have a very limited place in the correction of LTS. Of the open surgical techniques, laryngotracheal reconstruction (LTR) with cartilage grafting can precisely correct grade II and mild grade III stenosis with minimal morbidity and high decannulation rates. Partial cricotracheal resection (PCTR) can deliver high success rates for more severe stenoses, but it is a more complex procedure. Because LTR is more straightforward, it tends to be preferred for grade II and mild grade III stenosis. For a suitably experienced surgeon, PCTR is the preferred option for grade IV and severe grade III stenosis, especially where there is a clear margin between the stenosis and the vocal cords. The best chance for the patient lies in the first operation: this means that the surgeon managing the problem must be fully trained in paediatric airway endoscopy and laryngotracheal surgery, since inappropriate initial management of LTS may lead to permanent intractable sequelae.
摘要：
小儿喉气管狭窄（LTS）的外科重建仅在过去30年中得到发展，但是在此期间取得了巨大的进步，手术现在非常适合个体患者的需求。封闭（内窥镜）技术在LTS的矫正中具有非常有限的地位。在开放手术技术中，软骨移植喉气管重建（LTR）可以精确地纠正II级和轻度III级狭窄，发病率最低，脱管率高。部分环气管切除术（PCTR）可以为更严重的狭窄提供高成功率，但这是一个更复杂的过程。因为LTR更直接,对于II级和轻度III级狭窄，它往往是首选。对于一个有经验的外科医生来说，PCTR是IV级和严重III级狭窄的首选方案。尤其是狭窄和声带之间有明显的边缘。患者的最佳机会在于第一次手术：这意味着处理问题的外科医生必须接受儿科气道内窥镜检查和喉气管手术的全面培训，由于LTS的初始管理不当可能导致永久性的难治性后遗症。
