• Yu Chen, Wanyu Wen, Xinwei Du, Hao Wang, Limin Zhu, Shunmin Wang, Zhaohui Lu, Li Hong, and Ying Xiang.
• Department of Cardiac and Thoracic Surgery, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, 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 (OR=4.859, 95% 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. Additionally, 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--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 (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 CTS patients undergoing STP.Copyright © 2024. Published by Elsevier Inc.

4 keywords...

hide…