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December 4, 2025European Journal of Cardio-Thoracic Surgery1 citations

Surgical outcomes of postintubation or posttracheostomy tracheal stenosis including tracheoesophageal fistulas: a single-center experience in 519 consecutive cases

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MPMaciej T PawlicaJFJ FilipowiczMGMateusz Gadzala

Key Points

  • Tracheal resection led to low post-operative complications, achieving good long-term outcomes in 94% of patients without fistulas.
  • Short-term failures identified included older age, presence of a preoperative T-tube, and positive bacterial culture results.
  • Retrospective analysis highlighted significant risk factors, particularly for patients with tracheoesophageal fistulas.
  • Surgical outcomes revealed short-term success rates of 75%, 81%, and 91% across patient groups, focused on optimizing treatment strategies.

Abstract

Abstract OBJECTIVES Tracheal resection with end-to-end anastomosis is the gold-standard treatment for tracheal stenosis. Many risk factors may contribute to inadequate wound healing and treatment failure. We identified several of them and identified their influence on patients’ surgical outcomes. METHODS We reviewed patients with tracheal stenosis or tracheoesophageal fistula who underwent surgical segmental resection of the trachea. We grouped the patients into three groups: group I included patients with tracheoesophageal fistula(TEF), group II patients who underwent additional resection of the cricoid cartilage, and group III patients without the TEF or resection of cricoid cartilage. RESULTS In the multivariable analysis, for short-term failures, risk factors were: patients from group I (odds ratio (OR) 2.70, 95% CI 1.20–5.91), age 70 (OR 3.46, 05% CI 1.24–9.06), preoperative T-tube (OR 3.21, 95% CI 1.55–6.54) and positive bacterial culture (OR 1.77, 95% CI 0.98–3.23). For the long-term failures risk factors were: patients from group I (OR 6.92, 95% CI 2.74–17.74), group II (OR 2.85, 95% CI 1.24–6.58), age 60 (OR 2.67, 95% CI 1.26–5.58), preoperative T-tube (OR 6.67, 95% CI 3.04–14.78), and length of resection 2 cm (OR 2.42, 95% CI 1.10–6.11). Additionally, short-term good results were obtained in 75% of patients from group I, 81% from group II, and 91% from group III. Good long-term results obtained in groups I, II, and III were 75%, 83%, and 94% of cases respectively. CONCLUSIONS This is among the largest retrospective studies conducted so far. Tracheal resection is an effective treatment that results in low post-operative complications. Among other factors, the presence of TEF is a significant risk factor.

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Cite This Study

Pawlica et al. (2025) studied this question.

synapsesocial.com/papers/6930dc78ea1aef094cca216chttps://doi.org/10.1093/ejcts/ezaf358
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