New perspectives on tracheal resection for COVID-19–related stenosis: A propensity score matching analysis

ObjectiveThe large number of patients with COVID-19 subjected to prolonged invasive mechanical ventilation has been expected to result in a significant increase in tracheal stenosis in the next years. The aim of this study was to evaluate and compare postoperative outcomes of patients who survived COVID-19 critical illness and underwent tracheal resection for postintubation/posttracheostomy tracheal stenosis with those of non–COVID-19 patients.MethodsIt was single-center, retrospective study. All consecutive patients with post-intubation/posttracheostomy tracheal stenosis who underwent tracheal resection from February 2020 to March 2022 were enrolled. A total of 147 tracheal resections were performed: 24 were in post–COVID-19 patients and 123 were in non–COVID-19 patients. A 1:1 propensity score matching analysis was performed, considering age, gender, body mass index, and length of stenosis. After matching, 2 groups of 24 patients each were identified: a post–COVID-19 group and a non–COVID group.ResultsNo mortality after surgery was registered. Posttracheostomy etiology of stenosis resulted more frequently in post–COVID-19 patients (n = 20 in the post–COVID-19 group vs n = 11 in the non–COVID-19 group; P = .03), as well as intensive care unit admissions during the postoperative period (16 vs 9 patients; P = .04). Need for postoperative reintubation for glottic edema and respiratory failure was higher in the post–COVID-19 group (7 vs 2 postoperative reintubation procedures; P = .04). Postoperative dysphonia was observed in 11 (46%) patients in the post–COVID-19 group versus 4 (16%) patients in the non–COVID-19 group (P = .03).ConclusionsTracheal resection continues to be safe and effective in COVID-19–related tracheal stenosis scenarios. Intensive care unit admission rates and postoperative complications seem to be higher in post–COVID-19 patients who underwent tracheal resection compared with non–COVID-19 patients.Graphical abstract