Short-Term Outcomes of Tracheal Resection in The Society of Thoracic Surgeons Database

Bryan Payne Stanifer, Adin-Cristian Andrei, Menghan Liu, Shari Lynn Meyerson, Ankit Bharat, David Duston Odell, Malcolm M. DeCamp

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: Tracheal surgery is uncommon, and most of the published literature consists of single-center series over large periods. Our goal was to perform a national, contemporary analysis to identify predictors of major morbidity and mortality based on indication and surgical approach. Methods: The Society of Thoracic Surgeons General Thoracic Surgery Database (STS GTSD) was queried for all patients undergoing tracheal resection between 2002 and 2016. We identified 1,617 cases and compared outcomes by indication and approach. We created a multivariable model for a combined end point of mortality or major morbidity. The relationship between volume and outcome was analyzed. Results: The cervical approach was used 81% of the time, and benign disease was the indication in 75% of cases. Overall 30-day mortality was 1%, and no significant difference was found between the cervical and thoracic approach (1.1% versus 1.6%, p = 0.57) or between benign and malignant indications (1.1% versus 1.5%, p = 0.61). Independent factors associated with morbidity or mortality included thoracic approach, diabetes, and functional status. Centers were divided into those averaging fewer than four resections per year and those performing at least four per year. The low volume (<4) group had a combined morbidity and mortality of 27%, significantly higher than 17% observed among centers with more than four per year (p < 0.0001). Conclusions: STS GTSD participants perform tracheal resection for benign and malignant disease with low early morbidity and mortality. Higher operative volume is associated with improved outcome. Longer follow-up is needed to confirm airway stability and rate of reoperation.

Original languageEnglish (US)
Pages (from-to)1612-1618
Number of pages7
JournalAnnals of Thoracic Surgery
Volume106
Issue number6
DOIs
StatePublished - Dec 1 2018

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Databases
Mortality
Morbidity
Thorax
Thoracic Surgery
Reoperation

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Stanifer, Bryan Payne ; Andrei, Adin-Cristian ; Liu, Menghan ; Meyerson, Shari Lynn ; Bharat, Ankit ; Odell, David Duston ; DeCamp, Malcolm M. / Short-Term Outcomes of Tracheal Resection in The Society of Thoracic Surgeons Database. In: Annals of Thoracic Surgery. 2018 ; Vol. 106, No. 6. pp. 1612-1618.
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Short-Term Outcomes of Tracheal Resection in The Society of Thoracic Surgeons Database. / Stanifer, Bryan Payne; Andrei, Adin-Cristian; Liu, Menghan; Meyerson, Shari Lynn; Bharat, Ankit; Odell, David Duston; DeCamp, Malcolm M.

In: Annals of Thoracic Surgery, Vol. 106, No. 6, 01.12.2018, p. 1612-1618.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Short-Term Outcomes of Tracheal Resection in The Society of Thoracic Surgeons Database

AU - Stanifer, Bryan Payne

AU - Andrei, Adin-Cristian

AU - Liu, Menghan

AU - Meyerson, Shari Lynn

AU - Bharat, Ankit

AU - Odell, David Duston

AU - DeCamp, Malcolm M.

PY - 2018/12/1

Y1 - 2018/12/1

N2 - Background: Tracheal surgery is uncommon, and most of the published literature consists of single-center series over large periods. Our goal was to perform a national, contemporary analysis to identify predictors of major morbidity and mortality based on indication and surgical approach. Methods: The Society of Thoracic Surgeons General Thoracic Surgery Database (STS GTSD) was queried for all patients undergoing tracheal resection between 2002 and 2016. We identified 1,617 cases and compared outcomes by indication and approach. We created a multivariable model for a combined end point of mortality or major morbidity. The relationship between volume and outcome was analyzed. Results: The cervical approach was used 81% of the time, and benign disease was the indication in 75% of cases. Overall 30-day mortality was 1%, and no significant difference was found between the cervical and thoracic approach (1.1% versus 1.6%, p = 0.57) or between benign and malignant indications (1.1% versus 1.5%, p = 0.61). Independent factors associated with morbidity or mortality included thoracic approach, diabetes, and functional status. Centers were divided into those averaging fewer than four resections per year and those performing at least four per year. The low volume (<4) group had a combined morbidity and mortality of 27%, significantly higher than 17% observed among centers with more than four per year (p < 0.0001). Conclusions: STS GTSD participants perform tracheal resection for benign and malignant disease with low early morbidity and mortality. Higher operative volume is associated with improved outcome. Longer follow-up is needed to confirm airway stability and rate of reoperation.

AB - Background: Tracheal surgery is uncommon, and most of the published literature consists of single-center series over large periods. Our goal was to perform a national, contemporary analysis to identify predictors of major morbidity and mortality based on indication and surgical approach. Methods: The Society of Thoracic Surgeons General Thoracic Surgery Database (STS GTSD) was queried for all patients undergoing tracheal resection between 2002 and 2016. We identified 1,617 cases and compared outcomes by indication and approach. We created a multivariable model for a combined end point of mortality or major morbidity. The relationship between volume and outcome was analyzed. Results: The cervical approach was used 81% of the time, and benign disease was the indication in 75% of cases. Overall 30-day mortality was 1%, and no significant difference was found between the cervical and thoracic approach (1.1% versus 1.6%, p = 0.57) or between benign and malignant indications (1.1% versus 1.5%, p = 0.61). Independent factors associated with morbidity or mortality included thoracic approach, diabetes, and functional status. Centers were divided into those averaging fewer than four resections per year and those performing at least four per year. The low volume (<4) group had a combined morbidity and mortality of 27%, significantly higher than 17% observed among centers with more than four per year (p < 0.0001). Conclusions: STS GTSD participants perform tracheal resection for benign and malignant disease with low early morbidity and mortality. Higher operative volume is associated with improved outcome. Longer follow-up is needed to confirm airway stability and rate of reoperation.

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DO - 10.1016/j.athoracsur.2018.07.041

M3 - Article

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JO - Annals of Thoracic Surgery

JF - Annals of Thoracic Surgery

SN - 0003-4975

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ER -