• Yu Chen, Wanyu Wen, Xinwei Du, Hao Wang, Limin Zhu, Shunmin Wang, Li Hong, Zhaohui Lu, and Ying Xiang.
• Department of Cardiac and Thoracic Surgery, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, P.R. China.
• J. Thorac. Cardiovasc. Surg. 2024 Nov 22.

ObjectiveTo determine factors contributing to adverse postsurgical outcomes in children with congenital tracheal stenosis (CTS) treated with slide tracheoplasty (STP).MethodsWe employed regression models to evaluate the impact of preoperative or intraoperative features on postoperative airway complications, mechanical ventilation time, hospitalization, and survival among STP-treated patients with CTS.ResultsOutcomes from 271 patients with CTS undergoing STP were analyzed. Multivariate analysis showed that unilateral lung hypoplasia (odds ratio [OR], 4.859; 95% confidence interval [CI], 1.355-17.427) and bilateral bronchomalacia (OR, 3.774; 95% CI, 1.364-10.440) contributed to postoperative airway complications. Full-length stenosis (β = 0.192; 95% CI, 0.077-0.308), bilateral bronchomalacia (β = 0.153; 95% CI, 0.039-0.266), and secondary surgery (β = 0.269; 95% CI, 0.154-0.384) accounted for increased mechanical ventilation time. Using 99 hours as a benchmark, weight (OR, 0.818; 95% CI, 0.677-0.988) and bilateral bronchomalacia (OR, 2.960; 95% CI, 1.314-6.666) were factors for prolonged mechanical ventilation time. In addition, full-length stenosis (β = 0.221; 95% CI, 0.108-0.334), unilateral lung hypoplasia (β = 0.170; 95% CI, 0.060-0.280), unilateral bronchomalacia (β = 0.151; 95% CI, 0.038-0.265), and secondary surgery (β = 0.247; 95% CI, 0.138-0.356) were positively associated with the duration of hospitalization, whereas weight (β = -0.307; 95% CI, -0.561 to -0.054) was negatively correlated. Taking 21 days as a benchmark, weight (OR, 0.712; 95% CI, 0.569-0.891), full-length stenosis (OR, 2.997; 95% CI, 1.530-5.871), unilateral lung hypoplasia (OR, 10.079; 95% CI, 2.267-44.811), and reoperation (OR, 24.176; 95% CI, 2.685-217.667) associated with prolonged hospital stay. Weight (hazard ratio [HR], 0.167; 95% CI, 0.030-0.949) and tracheal diameter (HR, 0.172; 95% CI, 0.043-0.684) were positively correlated with survival.ConclusionsCareful assessment and management of perioperative conditions are essential to minimize risk of adverse postsurgical outcomes in patients with CTS undergoing STP.Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.

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