Background Tracheal and laryngotracheal surgery provides both excellent functional results and long-term outcomes in the treatment of tracheal stenosis. Consequently, challenging re-resections are rarely necessary. The purpose of this study was to compare the outcome of (laryngo-)tracheal re-resection and surgery after bronchoscopic interventions with that of primary surgery.

Methods Patients undergoing resection for benign tracheal stenosis at our center between 1/2016 and 4/2020 were included. Perioperative characteristics and functional outcomes of patients were used for statistical analysis.

Results Sixty-six patients who underwent (laryngo-)tracheal resection were included (previous resection [A = 6], previous stent [B = 6], previous bronchoscopic intervention w/o stenting [C = 19], untreated [D = 35]). Baseline parameters were largely comparable between groups with exception from group B that had significantly worse lung function. Group A necessitated more complex reconstructions (end-to-end: n = 1: 17%| cricotracheal n = 2: 33%| cricotracheal with mucosectomy n = 2: 33%| laryngoplasty: n = 1: 17%) than patients in group D (end-to-end n = 21: 60%| cricotracheal n = 14: 40%). Postoperative outcomes were comparable throughout groups (intensive care unit: 1[1–18] days; hospital stay: 8[5–71] days). Anastomotic complications were higher after previous stenting (A: 0%; B: 33.3%; C: 10.5%; D: 2.9%; B/D p = 0.008| surgical revisions: A: 16.7%; B: 33.3%; C: 0%; D: 5.7%; B/D, p = 0.035). Overall, postoperative lung function was significantly better (forced expiratory volume in 1 second: 63% ± 24 vs. 75% ± 20; p = 0.001 | PeakEF 3.3 ± 1.9 vs. 5.0 ± 2.2L; p = 0.001). No 90-day mortality was observed in any group. Median follow-up was 12(1–47) months.

Conclusion In carefully selected patients treated in a specialized center, tracheal or laryngotracheal resection after previous tracheal interventions provides comparable outcome to primary surgery.

背景 气管和喉气管手术在治疗气管狭窄方面提供了出色的功能结果和长期结果。因此，很少需要具有挑战性的再切除。本研究的目的是比较支气管镜介入后（喉）气管再切除和手术与初次手术的结果。

方法 纳入 2016 年 1 月至 2020 年 4 月在我中心接受良性气管狭窄切除术的患者。使用患者的围手术期特征和功能结果进行统计分析。

结果 包括 66 名接受（喉）气管切除术的患者（既往切除 [A = 6]，既往支架 [B = 6]，既往支气管镜介入治疗不使用支架 [C = 19]，未治疗 [D = 35 ]）。除了肺功能明显较差的 B 组之外，各组的基线参数在很大程度上具有可比性。A 组需要更复杂的重建（端到端：n  = 1：17%|环气管n  = 2：33%|环气管黏膜切除术n  = 2：33%|喉成形术：n  = 1：17%） D 组（端到端n  = 21: 60%| 环气管n = 14：40%）。各组的术后结果相当（重症监护室：1[1-18] 天；住院时间：8[5-71] 天）。先前支架术后吻合口并发症较高（A：0%；B：33.3%；C：10.5%；D：2.9%；B/D p  = 0.008| 手术修正：A：16.7%；B：33.3%；C： 0%；D：5.7%；B/D，p  = 0.035)。总体而言，术后肺功能明显改善（1 秒用力呼气量：63% ± 24 对 75% ± 20；p  = 0.001 | PeakEF 3.3 ± 1.9 对 5.0 ± 2.2L；p  = 0.001）。任何组均未观察到 90 天死亡率。中位随访时间为 12（1-47）个月。

结论 在经过精心挑选的在专业中心接受治疗的患者中，在先前的气管干预后进行气管或喉气管切除术可提供与初次手术相当的结果。