Management of obstructive peristomal complications in pediatric tracheostomy patients. A case series – Surgical decannulation

: Tracheal stenosis and suprastomal granuloma with collapse of the anterior tracheal wall are obstructive complications in pediatric tracheostomy patients. The objective of this study is to determine the safety and prognosis of surgical decannulation with simultaneous resection of the obstructive granuloma and tracheoplasty : A descriptive study between 2015 and 2024, seven children with obstructive complications associated with tracheostomy were included for surgical treatment with resection of suprastomal granuloma, stomoplasty and tracheoplasty simultaneously in surgical decannulation after failure of endoscopic treatment, surgical, endoscopic and prognostic characteristics are analyzed : Seven, with bronchopulmonary dysplasia (n = 4) and prolonged intubation (n = 3), all with obstructive suprastomal granulomas > 95% of the airway with failure of endoscopic resection, all with dynamic peristomal obstruction >75% and in 2 of them infrastomal tracheal stenosis Cotton III and IV, 5 were treated with granuloma resection, stomoplasty and anterior tracheoplasty achieving immediate extubation in 4 and one remained intubated for 24 hours due to supraglottic edema, and in 2 granuloma resection, anterior malacia and infrastomal stenosis with end-to-end tracheal anastomosis were performed, all with successful decannulation : Surgical decannulation in the treatment of obstructive peristomal complications in children with tracheostomy is a safe option, with low morbidity and no recurrence with zero mortality when endoscopic treatment has failed IV