Outcomes of redo and initial tracheal resection and anastomosis: A 25-year experience with insights from a propensity score-matched analysis.
- 1Tracheal Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
- 2Lung Transplantation Research Center, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Abstract
Objective
We aimed to compare the outcomes of tracheal resection and anastomosis (TRA) between patients undergoing initial tracheal resection and anastomosis (iTRA) and redo tracheal resection and anastomosis (reTRA).Methods
In this retrospective cohort, we used our prospectively collected database and patients who underwent TRA between March 2000 and March 2025 were included. We excluded operations performed for tracheal tumors, multisegmental stenosis, tracheoesophageal fistula, and those lost to follow-up. 1467 patients were included, of whom 51 had a history of TRA at other centers and 34 had both iTRA and reTRA at our institution, yielding 85 reTRA and 1416 iTRA cases. To ensure a well-balanced comparison, propensity-score matching (PSM) was performed, resulting in 71 matched pairs.Results
Postoperative outcomes were better after iTRA, with a greater rate of excellent outcomes (72.3% vs 58.3%, P = .005). This difference was no longer significant after PSM (odds ratio, 0.71; 95% CI, 0.38-1.32, P = .28). Failure rates were similar (10.0% vs 13.0%, P = .36) and remained similar after matching (P = 1.00). There were no significant differences in the rates of subcutaneous emphysema, wound infection, dehiscence, or required postoperative bronchoscopic dilatations. The only notable difference was a greater incidence of seroma/hematoma in reTRA before PSM (10.8% vs 5.0%, P = .01), which was not observed after PSM (10.0% vs 4.2%, P = .34).Conclusions
Redo TRA is not necessarily associated with greater rates of failure or complications. Although technically more challenging, redo TRA could be performed safely with comparable outcomes to initial TRA.
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BibTeX
@article{hasanzade2026outcomes,
title = {{Outcomes of redo and initial tracheal resection and anastomosis: A 25-year experience with insights from a propensity score-matched analysis.}},
author = {Arman Hasanzade and Fariba Ghorbani and Amir Ali Mahboobipour and Salman Soleimani and Mahboubeh Asadi and Azizollah Abbasi Dezfouli and Nahid Jahanshahi and Mohammad Behgam Shadmehr},
journal = {JTCVS open},
year = {2026},
month = aug,
doi = {10.1016/j.xjon.2026.102061},
url = {https://europepmc.org/article/MED/42948501},
note = {CC BY},
}
RIS
TY - JOUR
TI - Outcomes of redo and initial tracheal resection and anastomosis: A 25-year experience with insights from a propensity score-matched analysis.
AU - Arman Hasanzade
AU - Fariba Ghorbani
AU - Amir Ali Mahboobipour
AU - Salman Soleimani
AU - Mahboubeh Asadi
AU - Azizollah Abbasi Dezfouli
AU - Nahid Jahanshahi
AU - Mohammad Behgam Shadmehr
PY - 2026
DA - 2026/08/17
JO - JTCVS open
DO - 10.1016/j.xjon.2026.102061
UR - https://europepmc.org/article/MED/42948501
AB - Objective We aimed to compare the outcomes of tracheal resection and anastomosis (TRA) between patients undergoing initial tracheal resection and anastomosis (iTRA) and redo tracheal resection and anastomosis (reTRA).Methods In this retrospective cohort, we used our prospectively collected database and patients who underwent TRA between March 2000 and March 2025 were included. We excluded operations performed for tracheal tumors, multisegmental stenosis, tracheoesophageal fistula, and those lost to follow-up. 1467 patients were included, of whom 51 had a history of TRA at other centers and 34 had both iTRA and reTRA at our institution, yielding 85 reTRA and 1416 iTRA cases. To ensure a well-balanced comparison, propensity-score matching (PSM) was performed, resulting in 71 matched pairs.Results Postoperative outcomes were better after iTRA, with a greater rate of excellent outcomes (72.3% vs 58.3%, P = .005). This difference was no longer significant after PSM (odds ratio, 0.71; 95% CI, 0.38-1.32, P = .28). Failure rates were similar (10.0% vs 13.0%, P = .36) and remained similar after matching (P = 1.00). There were no significant differences in the rates of subcutaneous emphysema, wound infection, dehiscence, or required postoperative bronchoscopic dilatations. The only notable difference was a greater incidence of seroma/hematoma in reTRA before PSM (10.8% vs 5.0%, P = .01), which was not observed after PSM (10.0% vs 4.2%, P = .34).Conclusions Redo TRA is not necessarily associated with greater rates of failure or complications. Although technically more challenging, redo TRA could be performed safely with comparable outcomes to initial TRA.
SN - 2666-2736
ER -