Tracheal resection in patients post–COVID-19 is associated with high reintervention rate and early restenosisCentral MessagePerspective
Objectives: A remarkable increase in the number of patients presenting with tracheal complications after prolonged endotracheal intubation and mechanical ventilation for the management of the severe COVID-19–associated respiratory failure has been observed. In this study, we assessed the postoperati...
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Elsevier
2023-04-01
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| Series: | JTCVS Techniques |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666250723000093 |
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| author | Filippos-Paschalis Rorris, MD Evangelia Chatzimichali, MD Evangelia Liverakou, MD Constantine N. Antonopoulos, MD, PhD Evangelos Balis, MD Constantinos Kotsifas, MD Grigoris Stratakos, MD, PhD Antonia Koutsoukou, MD, PhD Charalampos Zisis, MD, PhD |
| author_facet | Filippos-Paschalis Rorris, MD Evangelia Chatzimichali, MD Evangelia Liverakou, MD Constantine N. Antonopoulos, MD, PhD Evangelos Balis, MD Constantinos Kotsifas, MD Grigoris Stratakos, MD, PhD Antonia Koutsoukou, MD, PhD Charalampos Zisis, MD, PhD |
| author_sort | Filippos-Paschalis Rorris, MD |
| collection | DOAJ |
| description | Objectives: A remarkable increase in the number of patients presenting with tracheal complications after prolonged endotracheal intubation and mechanical ventilation for the management of the severe COVID-19–associated respiratory failure has been observed. In this study, we assessed the postoperative outcomes of tracheal resection in patients with COVID-19. Methods: We conducted a retrospective study in which all patients with a history of prolonged invasive mechanical ventilation due to COVID-19 infection, who were treated with tracheal resection and reconstruction, were included. The primary objective was in-hospital mortality and postoperative reintervention rate. The secondary objective was the time to tracheal restenosis. Results: During the 16-month study period, 11 patients with COVID-19 with tracheal complications underwent tracheal resection with end-to-end anastomosis. Mean patient age was 51.5 ± 9 years, and the majority were male (9 patients). Eight patients were referred for management of postintubation tracheal stenosis, and 3 patients were referred for tracheoesophageal fistula. Eight patients had a history of tracheostomy during the COVID-19 infection hospitalization. There was 1 in-hospital death (9.1%) due to septicemia in the intensive care unit approximately 2 months after the operation. Postoperatively, 32 reinterventions were required for tracheal restenosis due to granulation tissue formation. The risk for reintervention was higher during the first 3 months after the index operation. Four patients developed tracheal restenosis (36.4%), and 2 of them required endotracheal stent placement during the follow-up period. Conclusions: Tracheal resection and reconstruction after COVID-19 infection are associated with a high reintervention rate postoperatively. Such patients require close follow-up in expert interventional pulmonology units, and physicians should be on high alert for the early diagnosis and optimal management of tracheal restenosis. Video Abstract: |
| format | Article |
| id | doaj-art-dfbe3b8743e645a78fdfba01c3f96b29 |
| institution | DOAJ |
| issn | 2666-2507 |
| language | English |
| publishDate | 2023-04-01 |
| publisher | Elsevier |
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| series | JTCVS Techniques |
| spelling | doaj-art-dfbe3b8743e645a78fdfba01c3f96b292025-08-20T03:04:59ZengElsevierJTCVS Techniques2666-25072023-04-011815716310.1016/j.xjtc.2023.01.006Tracheal resection in patients post–COVID-19 is associated with high reintervention rate and early restenosisCentral MessagePerspectiveFilippos-Paschalis Rorris, MD0Evangelia Chatzimichali, MD1Evangelia Liverakou, MD2Constantine N. Antonopoulos, MD, PhD3Evangelos Balis, MD4Constantinos Kotsifas, MD5Grigoris Stratakos, MD, PhD6Antonia Koutsoukou, MD, PhD7Charalampos Zisis, MD, PhD8Department of Thoracic and Cardiovascular Surgery, Evangelismos General Hospital, Athens, Greece; Address for reprints: Filippos-Paschalis Rorris, MD, Department of Thoracic and Cardiovascular Surgery, Evangelismos General Hospital, Ypsilantou 45-47, Athens, 106 76, Greece.Department of Thoracic and Cardiovascular Surgery, Evangelismos General Hospital, Athens, GreeceDepartment of Thoracic and Cardiovascular Surgery, Evangelismos General Hospital, Athens, GreeceDepartment of Vascular Surgery, “Attikon” University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, GreeceDepartment of Interventional Pulmonology, Evangelismos General Hospital, Athens, GreeceDepartment of Interventional Pulmonology, Evangelismos General Hospital, Athens, GreeceDepartment of Interventional Pulmonology, 1st Department of Pulmonology, Medical School, University of Athens, “Sotiria” Hospital, Athens, GreeceDepartment of Interventional Pulmonology, 1st Department of Pulmonology, Medical School, University of Athens, “Sotiria” Hospital, Athens, GreeceDepartment of Thoracic and Cardiovascular Surgery, Evangelismos General Hospital, Athens, GreeceObjectives: A remarkable increase in the number of patients presenting with tracheal complications after prolonged endotracheal intubation and mechanical ventilation for the management of the severe COVID-19–associated respiratory failure has been observed. In this study, we assessed the postoperative outcomes of tracheal resection in patients with COVID-19. Methods: We conducted a retrospective study in which all patients with a history of prolonged invasive mechanical ventilation due to COVID-19 infection, who were treated with tracheal resection and reconstruction, were included. The primary objective was in-hospital mortality and postoperative reintervention rate. The secondary objective was the time to tracheal restenosis. Results: During the 16-month study period, 11 patients with COVID-19 with tracheal complications underwent tracheal resection with end-to-end anastomosis. Mean patient age was 51.5 ± 9 years, and the majority were male (9 patients). Eight patients were referred for management of postintubation tracheal stenosis, and 3 patients were referred for tracheoesophageal fistula. Eight patients had a history of tracheostomy during the COVID-19 infection hospitalization. There was 1 in-hospital death (9.1%) due to septicemia in the intensive care unit approximately 2 months after the operation. Postoperatively, 32 reinterventions were required for tracheal restenosis due to granulation tissue formation. The risk for reintervention was higher during the first 3 months after the index operation. Four patients developed tracheal restenosis (36.4%), and 2 of them required endotracheal stent placement during the follow-up period. Conclusions: Tracheal resection and reconstruction after COVID-19 infection are associated with a high reintervention rate postoperatively. Such patients require close follow-up in expert interventional pulmonology units, and physicians should be on high alert for the early diagnosis and optimal management of tracheal restenosis. Video Abstract: http://www.sciencedirect.com/science/article/pii/S2666250723000093bronchoscopyCOVID-19reinterventionstracheal resectiontracheal surgery |
| spellingShingle | Filippos-Paschalis Rorris, MD Evangelia Chatzimichali, MD Evangelia Liverakou, MD Constantine N. Antonopoulos, MD, PhD Evangelos Balis, MD Constantinos Kotsifas, MD Grigoris Stratakos, MD, PhD Antonia Koutsoukou, MD, PhD Charalampos Zisis, MD, PhD Tracheal resection in patients post–COVID-19 is associated with high reintervention rate and early restenosisCentral MessagePerspective JTCVS Techniques bronchoscopy COVID-19 reinterventions tracheal resection tracheal surgery |
| title | Tracheal resection in patients post–COVID-19 is associated with high reintervention rate and early restenosisCentral MessagePerspective |
| title_full | Tracheal resection in patients post–COVID-19 is associated with high reintervention rate and early restenosisCentral MessagePerspective |
| title_fullStr | Tracheal resection in patients post–COVID-19 is associated with high reintervention rate and early restenosisCentral MessagePerspective |
| title_full_unstemmed | Tracheal resection in patients post–COVID-19 is associated with high reintervention rate and early restenosisCentral MessagePerspective |
| title_short | Tracheal resection in patients post–COVID-19 is associated with high reintervention rate and early restenosisCentral MessagePerspective |
| title_sort | tracheal resection in patients post covid 19 is associated with high reintervention rate and early restenosiscentral messageperspective |
| topic | bronchoscopy COVID-19 reinterventions tracheal resection tracheal surgery |
| url | http://www.sciencedirect.com/science/article/pii/S2666250723000093 |
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