Age-related difficulty in post-intubation tracheal stenosis reconstruction: a comparative analysis of CO2-laser, resection and anastomosis, and costal cartilage grafting techniques

Abstract

Abstract Background Costal cartilage graft (CCG) sustains primary donor material for laryngotracheal reconstruction in patients with post-intubation tracheal stenosis (PITS). But, the elasticity and viability of CCG decrease elderly. This study was aimed to examine the age factor in PITS cases according to the treatment groups, especially in the tracheal reconstruction surgery with CCG group. Methods This retrospective study was designed. Patients with a diagnosis of PITS were enrolled. The hazard ratio was calculated with the Cox regression model to define independent risk factors for failure among the variables. Results Eighty-five patients diagnosed with post-intubation tracheal stenosis (PITS) were enrolled in the study. Restenosis developed in 19 (22.4%) patients. The failure rate in patients aged 40 years and older was 7.5 times higher on average compared to patients under 40 years of age (p = 0.004, 95% CI: 1.6–35.2). Additionally, age group ≥ 40 and CCG treatment group were a significant risk factors for surgical failure (p = 0.012, HR = 0.0003, 95% CI for HR = 0.0000006–0.173, and p < 0.001, HR = 0.001, 95%CI for HR = 0.000025–0.047, respectively). Conclusions Age and CCG group were detected as independent risk factors for surgical failure, possibly due viability of costal cartilage.

Keywords

• Costal cartilage
• Tracheal stenosis
• CO2 laser
• Laryngotracheal reconstruction
• Decannulation failure