Colonization by Staphylococcus aureus Predicts Postoperative Complications After Tracheoplasty for Airway Stenosis

Colonization by Staphylococcus aureus Predicts Postoperative Complications After Tracheoplasty for Airway Stenosis | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Colonization by Staphylococcus aureus Predicts Postoperative Complications After Tracheoplasty for Airway Stenosis José Alberto Choreño-Parra, Francisco Bernardo Pérez-Orozco, Adán Yavé González-Trejo, and 13 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8354585/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 11 You are reading this latest preprint version Abstract Background Tracheoplasty offers definitive treatment for high-grade tracheal stenosis but carries a high risk of postoperative complications. While structural and clinical predictors have been widely studied, the influence of airway colonization and antibiotic prophylaxis remains unclear. The objective of this study was to identify clinical, anatomical, and microbiological predictors of postoperative complications in patients undergoing tracheal resection and end-to-end anastomosis. Methods We conducted a retrospective cohort study of 87 adult patients who underwent tracheoplasty at a national referral center. Demographic, anatomical, surgical, and microbiological data were collected. Airway colonization was defined by positive cultures obtained preoperatively. Prophylactic antibiotic use was defined as systemic antibiotics administered within 24 hours of surgery. Multivariable logistic regression was used to identify predictors of overall and specific complications. Results At least one postoperative complication occurred in 39% of patients, with 26% occurring at the anastomosis site. Predictors of complications included multisegmental or complex stenosis, higher Cotton classification, and greater intraoperative blood loss. Airway colonization with Staphylococcus aureus was a strong independent predictor of several complications, including pneumonia (OR 21.7, q = 0.002), tracheitis, dehiscence, and surgical reintervention. Colonization with drug-resistant or multiple organisms further increased risk. Viral isolates had no measurable impact on outcomes. Despite being administered in 80% of patients, protocolized antibiotic prophylaxis showed no association with reduced complications or infection-related events. Conclusions Microbiological colonization, particularly with S. aureus , is a key predictor of adverse outcomes after tracheoplasty, independent of structural severity or comorbidities. Our results support the need for microbiology-informed perioperative strategies to reduce morbidity. Trial registration: This was a retrospective observational cohort study conducted using routinely collected clinical data. As no intervention was prospectively assigned and no randomization or protocol-driven treatment allocation was performed, this study does not qualify as a clinical trial and was therefore not registered. Airway obstruction Tracheoplasty Airway colonization Postoperative complications Staphylococcus aureus Introduction Tracheal stenosis is a debilitating condition with a variety of etiologies, including trauma, prolonged orotracheal intubation (OIT) [ 1 ], tracheostomy [ 2 ], neoplasms, and inflammatory disorders such as systemic vasculitis [ 3 , 4 ]. This narrowing of the airway can severely compromise tracheal patency and lead to respiratory distress, necessitating intervention. Unfortunately, evidence in favor of medical therapies such as the use of systemic steroids in preventing and treating tracheal stenosis is scarce [ 5 ]. Furthermore, while bronchoscopy dilation offers temporary relief, recurrence is frequent [ 6 , 7 ], and complementary interventions are often required [ 8 – 10 ], with most patients with anatomically suitable lesions ultimately requiring definitive tracheoplasty. Despite surgical technique improvements, the procedure remains associated with significant risk for postoperative complications, particularly at the site of anastomosis, which can lead to dehiscence, restenosis, and infection [ 11 – 17 ]. Research has identified several clinical and surgical factors contributing to complications following tracheoplasty [ 18 – 23 ]. Some of these predictors include the need for a second tracheoplasty, the presence of diabetes, the extent of resections (especially long-segment), involvement of the laryngotracheal area, younger age, and a history of prior tracheostomy [ 18 ]. These findings emphasize the multifaceted nature of postoperative risk and illustrate the critical importance of thorough preoperative evaluations, which should include careful patient selection and meticulous surgical planning. However, while much attention has been given to patient- and procedure-related variables, the influence of microbiological factors on tracheoplasty results has not been extensively studied. The colonization of the airway by pathogenic bacteria can hinder mucosal healing and incite local inflammatory responses, elevating the risk of postoperative adverse outcomes. These effects are particularly pertinent in patients with a history of airway stenting, tracheostomy, or repeated endoscopic interventions [ 24 – 32 ]. Here, we sought to evaluate both clinical and microbiological predictors of adverse outcomes following tracheoplasty performed for traumatic or tumoral stenosis. Methods Study Design and Population We conducted a retrospective cohort study at a national reference center for airway disorders. The objective was to evaluate clinical and microbiological predictors of adverse outcomes following tracheoplasty. The study included all consecutive adult patients (aged ≥18 years) who underwent tracheal resection and anastomosis between April 1, 2023, and March 31, 2025. Despite clinical registries of potential participants being available in the electronic database since 2019, this period was chosen to ensure uniformity in surgical and perioperative protocols, avoiding the effects of resource reallocation during the COVID-19 outbreak. Patients were eligible for inclusion if they had a diagnosis of tracheal stenosis due to traumatic injury (OIT, tracheostomy) or tumoral obstruction. The diagnosis and surgical indication were established via multidisciplinary evaluation that included thoracic surgeons, otorhinolaryngologists, pulmonologists, anesthesiologists, and infectious diseases specialists, with preoperative confirmation through computed tomography (CT) and flexible bronchoscopy. Exclusion criteria included bronchial involvement, systemic vasculitis or other inflammatory disorders, congenital airway anomalies, idiopathic stenosis, active respiratory infections at the time of surgery, or incomplete medical records. We also excluded patients who had undergone prior tracheoplasty at other institutions to ensure uniformity in surgical technique and perioperative care. Postoperative Care Protocol for Tracheoplasty Patients At our institution, most patients undergoing tracheoplasty are admitted electively following a comprehensive preoperative protocol, which includes multidisciplinary evaluations by internal medicine, nutrition, cardiology, neurology, and psychiatry. This workup serves to exclude patients at high risk of postoperative complications and prevent seizures or psychological inability to maintain cervical flexion for the required postoperative surveillance period. During the preoperative assessment, patients undergo both diagnostic and therapeutic bronchoscopy, along with imaging studies including CT with airway reconstruction to facilitate surgical planning. Immediately after surgery, patients are transferred to the postoperative care unit located adjacent to the operating rooms. This unit functions as a critical care area equipped to provide advanced intensive care interventions, including extracorporeal membrane oxygenation (ECMO) if needed. All patients are extubated in the operating room. If extubation is not feasible, or if a high risk of complications is anticipated by the surgeon (history of vocal cord paralysis, large segment to be resected, among others), a protective tracheostomy is performed distal to the anastomotic site. Patients with tracheostomy below the site of stenosis who did not complete a decannulation protocol in the preoperative period are not excluded from the procedure and keep their cannula in place after the surgery. Postoperative care includes oxygen therapy via a humidified face mask, non-opioid analgesia to minimize nausea, voice rest, and assisted cervical flexion. Some patients receive prophylactic antibiotics to minimize wound infection risk at the discretion of the attending thoracic surgeon. Any of the postoperative interventions may be modified or omitted as considered by the surgical team. Data Collection Data were extracted from electronic clinical records using a structured abstraction form developed by the study team. Demographic information included age, sex, and body mass index (BMI). Comorbidities were recorded based on medical history and included diabetes, systemic arterial hypertension (SAH), chronic respiratory disease, obesity (BMI ≥30 kg/m²), psychiatric illness, and neurologic impairment (e.g., stroke, traumatic brain injury). We also recorded behavioral risk factors such as tobacco use. Stenosis characteristics were documented based on bronchoscopy and surgical findings. These included minimum luminal diameter (in millimeters), length of the stenotic segment (in centimeters), anatomical location (upper, middle, or lower third of the trachea), complexity (classified as simple or complex based on mucosal integrity and presence of granulation tissue), and multisegmented involvement (defined as stenosis affecting more than one contiguous tracheal region). The etiology of stenosis was classified as traumatic (post-intubation or tracheostomy) or tumoral. Surgical variables included the number of tracheal rings resected, the total duration of surgery (in minutes), and estimated intraoperative blood loss. All tracheoplasties were performed by the institution’s thoracic surgical and otorhinolaryngology teams using standardized techniques involving circumferential resection and tension-free end-to-end anastomosis. Airway caliber was assessed intraoperatively using flexible bronchoscopy, and intraoperative complications were recorded when applicable. As part of the surgical assessment, we also reviewed pathological reports from tracheal specimens obtained during resection. Histopathological variables of interest were extracted from formal pathology reports and categorized as present or absent. All specimens were evaluated by board-certified pathologists with expertise in pulmonary and airway pathology, using hematoxylin and eosin staining and standard diagnostic criteria. Microbiological Assessment Assessment of airway colonization was based on respiratory specimens collected from each patient within 30 days before surgery or the first 48 hours postoperatively, provided there was no clinical evidence of active infection (i.e., fever, elevated inflammatory markers, or purulent secretions). Samples included oropharyngeal/nasopharyngeal swab specimens, sputum, tracheal aspirates, or bronchoalveolar lavage fluid, depending on patient status and clinical indication. All samples were processed in the hospital’s microbiology laboratory using conventional bacterial cultures and a multiplex polymerase chain reaction (PCR) panel designed to detect common respiratory pathogens. Viral and fungal identification were also recorded if detected. Colonization was defined as the presence of microbial growth or a positive PCR result in the absence of systemic or localized signs of infection. Patients were categorized based on colonization status and the specific pathogen identified. Repeated cultures were obtained during hospitalization only if new clinical symptoms developed. Antibiotic Exposure Postoperative antibiotic prophylaxis was defined as the administration of at least one dose of systemic antibiotics with prophylactic intent (typically 30 minutes before the procedure or within 24 hours postoperatively). In most cases, the use of antibiotics was not tailored to microbiological findings. Patients were stratified according to whether they received prophylactic antibiotics, and subsequent therapeutic antibiotic use was recorded when indicated for new or worsening clinical signs of active infection. Outcomes The primary outcome was the occurrence of at least one postoperative complication at any time during the postoperative follow-up. Specific complications at the anastomosis site or systemic complications were also analyzed individually. These included one or more of the following events: anastomotic dehiscence or restenosis, surgical site infection, tracheitis, hematoma, non-residual hemoptysis, hospital-acquired pneumonia, need for invasive mechanical ventilation (IMV), in-hospital mortality, and long-term sequela, like tracheoesophageal fistula, dysphonia, and dysphagia. The need for airway instrumentation by bronchoscopy or surgical reintervention after the primary procedure was also recorded as a response variable. Complications were adjudicated by independent clinicians not involved in the initial surgery. Other variables of interest included the length of postoperative hospitalization and the need for escalation of antibiotic therapy. Statistical Analysis Descriptive statistics were used to summarize patient demographics, clinical variables, surgical characteristics, and outcomes. Categorical variables were reported as frequencies and percentages, and continuous variables were expressed as medians with interquartile ranges (IQR). Comparisons between groups were performed using Pearson’s Chi-squared test or Fisher’s exact test for categorical data and Wilcoxon rank sum test for continuous data. Logistic regression for key clinical, surgical, and microbiological factors was used to identify predictors of complications after tracheoplasty. Given the exploratory nature of the study and the limited sample size, multivariate models were not constructed to minimize the risk of overfitting. Results were reported as odds ratios (OR) with 95% confidence intervals (CI). To account for multiple testing, false discovery rate (FDR) correction was applied to univariate logistic regression models using the Benjamini–Hochberg method, and q-values were calculated. While results were primarily interpreted as suggestive of association based on unadjusted p-values < 0.05 to identify potential predictors of outcomes, q-values (< 0.1) were reported to highlight independent predictors with robust association. All statistical analyses were performed using R software (version 4.1.2, R Foundation for Statistical Computing, Vienna, Austria) and GraphPad Prism (version 9.5, La Jolla, CA, USA). A two-sided p-value of <0.05 was considered statistically significant. Detailed test results are presented in the relevant tables and figure legends. Results Patient Characteristics A total of 99 patients who underwent tracheoplasty since 2019 were identified in the electronic database of our center. Of these, 87 patients were eligible for the analysis as they received surgery within the established study period. Their demographic characteristics are summarized in Table 1 . The median age was 32 years with a predominance of males. Common comorbidities included SAH (17%), diabetes (11%), and smoking history (39%). Neurological impairment secondary to trauma or cerebrovascular events was present in 41%, and 14% had documented psychiatric disorders. Regarding nutritional status, 31% were overweight, 11% were obese, and 4.6% presented with undernutrition. The predominant etiology of tracheal stenosis was traumatic, related to prolonged OIT in 90% of cases. The median duration of intubation was 11.5 days. Nearly 89% of patients had complex stenosis, and 9.2% had multisegmented involvement. According to the Cotton classification, 95% had grade III-IV stenoses, with a median minimum luminal diameter of 5 mm and a stenosis length of 2.0 cm ( Table 2 ). Intervention history and characteristics of tracheoplasty procedures performed in study participants are summarized in Table 3 . Preoperative management frequently involved endoscopic interventions. Balloon dilation was performed in 70% of patients (median of one procedure per patient), and 18% underwent laser ablation. Inhaled corticosteroids were prescribed at least once at any time during the preoperative period in 64%, and systemic corticosteroids in 31%. Only 3.4% had prior stent placement, and 4.6% had a Montgomery T-tube. A total of 26 patients (30%) had received antibiotics before surgery to treat documented respiratory infections. These infections occurred outside the 30-day preoperative window used to define airway colonization and were therefore not considered in the assessment of perioperative microbiological status. The median duration of antibiotic exposure before surgery in these cases was three days (IQR: 0–4). Most patients (97%) underwent their first tracheal resection (primary tracheoplasty), with a median of four tracheal rings resected and a surgical duration of 4.0 hours. The median intraoperative blood loss was 100 mL, and most anastomoses were cricotracheal (55%). Differences Across Groups According to Outcomes When we analyze the full range of possible complications, 33 patients experienced at least one adverse outcome after surgery. The median number of complications per affected patient was three. The most frequent complications are described in Table 4 . Only 23 patients (26%) had a direct compromise of the anastomotic site (dehiscence and/or restenosis). Two deaths occurred during the postoperative period, one related to hospital-acquired pneumonia and sepsis, the other due to anastomosis dehiscence. Patients were grouped according to the presence of at least one systemic or anastomosis site complication, including the requirement of any reintervention procedure during follow-up. Although re-intervention procedures are not per se a complication, they reflect subsequent use of resources due to postoperative morbidity. As such, several distinctions were evident between patient groups. Patients who developed complications were significantly more likely to have complex, multisegmented stenosis ( Table 2 ) and experienced higher intraoperative blood loss ( Table 3 ). While demographic and nutritional profiles were similar between groups, there were higher but not statistically significant frequencies of diabetes and SAH among those who experienced complications ( Table 1 ). No significant differences were noted in other comorbidities, prior interventions, histopathological features ( Table S1 ), or laboratory parameters ( Table S2 ). Microbiologically, bacterial colonization was substantially more prevalent among patients with complications. The most frequent isolates are summarized in Table 5 . S. aureus was the most prevalent microorganism, identified with higher frequency in patients with complications compared to those without adverse surgical outcomes. Interestingly, viruses were isolated in 14% of participants but showed no different distribution among groups according to outcomes. Predictors of Postoperative Complications A univariate logistic regression analysis was conducted to identify factors associated with postoperative complications ( Table 6 ). Colonization by S. aureus emerged as the most powerful predictor, followed by the presence of any bacterial isolate and the number of isolates per patient. Drug resistance also significantly increased the odds of complications. Anatomical and procedural characteristics were also predictive but not independent risk factors, as they reached no statistical significance after correction for multiple comparisons. Multisegmented stenosis was associated with a fivefold increase in complication risk, while complex stenosis showed a similar effect. Higher intraoperative blood loss was modestly predictive. Further analysis of individual postoperative complications revealed distinct and clinically relevant associations ( Table S3 ). To ensure statistical robustness, logistic regression was performed only for complications occurring in approximately 10% or more of the study population. Accordingly, less frequent events were excluded from modeling due to insufficient event count. Among the complications with adequate frequency, S. aureus colonization emerged as a central predictor significantly associated with tracheitis, anastomotic dehiscence, need for permanent tracheostomy, and surgical/bronchoscopy reintervention. Notably, it was an independent risk factor for hospital-acquired pneumonia. In addition to S. aureus , a higher number of isolates per patient and the presence of any bacterial isolate were consistently associated with multiple complications, particularly pneumonia, tracheitis, and permanent tracheostomy. Blood loss during surgery was relevant for reintervention, restenosis, development of granulation tissue, tracheitis, dysphonia, and was only independently associated with pneumonia. Tracheitis was independently associated not only with microbial factors but also with host factors, including epilepsy, elevated gamma-glutamyl transferase (GGT), and prothrombin time. Similarly, dehiscence showed strong associations with drug-resistant colonization and elevated GGT, suggesting a complex interplay between microbial virulence and systemic inflammation. Pneumonia, one of the most severe complications, was associated with a broad array of factors beyond microbiological predictors. These included age, diabetes, preoperative inhaled steroid use, prolonged antibiotic exposure before surgery, and the use of mucolytics. Restenosis correlated with the Cotton classification of the initial stenosis. Finally, the need for reintervention closely followed the distribution of airway infections and dehiscence events. Although in-hospital mortality was low (2.3%), both patients who died had complex stenosis, diabetes, and S. aureus colonization. Role of Antibiotics Prophylactic antibiotic administration was applied in 80% of patients at the discretion of the surgical team, typically for three days (IQR: 1–3). No differences in the proportion of patients who developed any complication were observed between patients according to antibiotic prophylaxis exposure. In contrast to prophylaxis, therapeutic antibiotics were only prescribed when infection was clinically diagnosed, defined by the combination of new or worsening respiratory symptoms, elevated inflammatory markers, and the identification of pathogens not previously isolated. This approach was necessary in 61% of patients with complications, compared to only 15% of those without (p < 0.001; Table 3 ). The most used antibiotics were ceftriaxone, piperacillin-tazobactam, and amoxicillin-clavulanate. Discussion Tracheoplasty remains a technically demanding yet potentially curative intervention for patients with high-grade tracheal stenosis [ 3 ]. Despite advances in surgical technique and perioperative care, the procedure continues to be associated with significant postoperative morbidity [ 11 – 17 ]. Historically, attention has focused primarily on anatomical and procedural variables, such as the degree and length of stenosis, its proximity to the glottis, and the complexity of resection, as well as host comorbidities in predicting outcomes [ 18 ]. However, relatively little has been published on the contribution of airway microbiology as a potential determinant of surgical complications. Our study represents one of the first systematic attempts to simultaneously assess clinical, anatomical, surgical, and microbiological predictors of adverse outcomes following tracheoplasty. Many of our findings are consistent with prior reports that have identified age, diabetes, and the presence of systemic inflammatory conditions as significant determinants of postoperative outcomes [ 18 – 21 ]. Similarly, anatomical variables, including etiology of stenosis, glottic involvement, vocal cord dysfunction, multisegmental disease, and prior reconstructive attempts, have been associated with increased surgical risk. These data have informed the establishment of preoperative exclusion criteria in many high-volume centers, where patients with lesions longer than 4 cm, glottic proximity, or a history of failed reconstruction may be deemed unsuitable for resection [ 3 ]. In our study, we observed that higher Cotton classification, multisegmental involvement, and complex stenoses were significantly associated with a greater likelihood of complications, reinforcing the prognostic value of these structural features. Nonetheless, our findings also shed light on additional contributors that may explain the heterogeneity of outcomes reported across centers. Compared to previous reports from high-resource institutions [ 18 ], we observed a higher overall complication rate, although most adverse outcomes were mild, and mortality remained similarly low. This discrepancy is consistent with data from public institutions in low- and middle-income settings, where delayed referral, limited access to diagnostic modalities, and resource constraints may contribute to worse outcomes [ 20 , 22 ]. Our hospital is a publicly funded national referral center that primarily serves uninsured and socioeconomically disadvantaged populations. Patients are frequently referred late in the disease course, often with poorly controlled comorbidities, previous failed interventions, or without adequate preoperative optimization. As others have noted, socioeconomic and structural healthcare disparities significantly influence outcomes in major airway surgery [ 22 ]. Beyond confirming known clinical predictors, we provide novel insights into perioperative variables not routinely assessed in previous studies. Notably, intraoperative blood loss emerged as a consistent potential predictor of multiple adverse events, including restenosis, granulation tissue formation, tracheitis, pneumonia, dysphonia, and the need for subsequent reintervention at any time during follow-up. While this parameter is often overlooked in outcome models, our findings suggest that greater intraoperative hemorrhage may reflect more technically challenging resections or compromised vascular integrity at the anastomotic site, factors that could adversely affect healing and predispose to infection or structural failure. Perhaps the most striking and clinically actionable finding of our study is the robust association between airway colonization with S. aureus and postoperative complications. Although prior studies have hinted at the role of infection in anastomotic failure or restenosis [ 19 ], few have systematically evaluated preoperative colonization as a risk marker. In this regard, our study expands the scope of risk assessment by incorporating a detailed description of the microbial spectrum affecting this population, including different microorganism species. Interestingly, the detection of respiratory viruses, though relatively frequent, did not correlate with an increased risk of postoperative complications. This suggests that in the absence of clinical signs of acute infection, incidental viral identification may not warrant deferral of surgery [ 33 ]. In contrast, bacterial colonization, especially with S. aureus , was strongly associated with virtually every major complication. These associations persisted even after adjusting for multiple comparisons, highlighting the potential role of microbial pathogenicity and host-microbe interactions in surgical outcomes. Additionally, polymicrobial colonization and the presence of drug-resistant organisms further increased the risk of specific complications. Nouraei SA, et al., in 2006, demonstrated that colonization of airway stents with S. aureus and P. aeruginosa was strongly associated with persistent granulation of the airway, a common cause of failure after tracheal reconstruction [ 29 ]. They suggested that antibiotic coverage of these microorganisms must be among the preventive measures for patients candidates for laryngotracheoplasty. The potential mechanistic basis for our most remarkable observation lies in several S. aureus virulence factors that alter the integrity and function of the airway epithelium. As such, in vitro models using air-liquid interface cultures of airway epithelial cells have uncovered soluble factors secreted by S. aureus that exert a direct disrupting effect on tight junction proteins, such as the alpha hemolysin (Hla) [ 34 , 35 ]. In addition, S. aureus superantigens and enterotoxins induce a persistent local inflammatory reaction in the airway epithelium, which disrupts the integrity of the barrier, hinders its re-epithelialization, and promotes infection. Emerging evidence exists on the specific induction of a T2 inflammatory profile by these bacterial products in the airways that also promotes tissue damage and fibrosis, as observed in patients with chronic sinusitis, allergic rhinitis, and asthma [ 36 , 37 ]. Of great interest is the observation made by Yamada Y, et al., 2001, who identified a relationship between the development of acquired airway stenosis and tracheal infection by a methicillin-resistant S. aureus strain producing the epidermal cell differentiation inhibitor (EDIN) toxin in two children [ 38 ]. EDIN belongs to a class of exotoxins capable of disrupting Rho GTPase activity, thereby impairing epithelial cell migration and promoting endothelial barrier dysfunction [ 39 ]. While our study did not directly assess EDIN expression, the magnitude of association between S. aureus colonization and key healing-related complications in our cohort raises the possibility that similar mechanisms may be at play in adult tracheal surgery. These data warrant further microbiological and translational investigation to characterize virulence profiles of S. aureus isolates in airway-colonized patients. Perhaps more importantly, the consistent association between microbiological factors and adverse clinical outcomes might prompt some surgical teams to adopt perioperative antibiotic prophylaxis as a routine strategy to mitigate complications. However, our findings challenge this widespread yet largely unexamined practice. In our cohort, prophylaxis was not associated with a lower incidence of any clinical outcome, including infection-related events. These results support the need to re-evaluate current perioperative antibiotic protocols and explore microbiology-guided strategies instead of empirical use in airway surgery. Conclusions Our study highlights the importance of adopting a multidimensional approach to risk assessment in tracheoplasty. Our results reaffirm the significance of established risk factors, such as comorbidities and the complexity of stenosis. More importantly, we identified bacterial colonization, especially by S. aureus , as a robust, independent predictor of postoperative complications. Interestingly, despite the widespread prescription of protocolized postoperative antibiotic prophylaxis by surgical teams, our findings indicated no significant correlation between this practice and a reduction in adverse events. These results suggest that a more effective and rational approach to improving surgical outcomes in tracheal reconstruction may lie in the preoperative identification of airway colonization, coupled with the development and application of targeted antimicrobial strategies, rather than relying solely on routine, non-selective antibiotic prophylaxis. Abbreviations BMI, body mass index; CI, confidence intervals; COVID-19, coronavirus disease 2019; CT, computed tomography; ECMO, extracorporeal membrane oxygenation; EDIN, epidermal cell differentiation inhibitor; FDR, false discovery rate; GGT, gamma-glutamyl transferase; IMV, invasive mechanical ventilation; IQR, interquartile range; OIT, orotracheal intubation; OR, odds ratio; PCR, polymerase chain reaction; SAH, systemic arterial hypertension. Declarations Ethics approval and consent to participate The study was conducted in accordance with the Declaration of Helsinki and was approved by the Institutional Review Board and Ethics Committee of the Instituto Nacional de Enfermedades Respiratorias “Ismael Cosío Villegas” (INER), Mexico City. All study participants provided written informed consent. Given the retrospective observational design and the use of anonymized data, trial registration was not required. Consent for publication Not applicable. This study did not include any identifiable individual patient data. Availability of data and materials The datasets generated and/or analyzed during the current study are available from the corresponding author on reasonable request. Competing interests The authors declare that they have no competing interests. Funding This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors. Authors´ contributions JACP, FBPO, JDCA, CMHC, MCL, GHS, conceived and designed the study. JACP, AYGT, IMB, MAIG, JFAV, GLV, ATG, SRB, KSG, AAG, collected and curated the data. JACP, MCL performed the statistical analysis. JACP, FBPO, MAIG, JLCA, MCL, GHS interpreted the data. JACP, MAIG, JLCA, MCL, GHS drafted the manuscript. All authors critically revised the manuscript for important intellectual content and approved the final version of the manuscript. Acknowledgements None. References Wain JC: Postintubation tracheal stenosis . 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J Biol Chem 1992, 267 (4):2600-2604. Tables Table 1. Participant characteristics Characteristics Overall , N = 87 1 Any complication No , N = 54 1 Yes , N = 33 1 p-value 2 Demographics Age, years 32 (22.5, 47) 34 (22, 43.8) 30 (23, 50) >0.9 Male 58 (67%) 38 (70%) 20 (61%) 0.3 BMI, kg/m 2 24 (22, 26.8) 23.3 (21.8, 26.2) 24.8 (22.7, 27.3) 0.14 Comorbidities Neurological sequela 36 (41%) 24 (44%) 12 (36%) 0.5 Smoking 34 (39%) 24 (44%) 10 (30%) 0.2 Overweight 27 (31%) 16 (30%) 11 (33%) 0.7 SAH 15 (17%) 7 (13%) 8 (24%) 0.2 Epilepsy 12 (14%) 5 (9.3%) 7 (21%) 0.2 Psychiatric disorder 12 (14%) 8 (15%) 4 (12%) >0.9 Obesity 10 (11%) 5 (9.3%) 5 (15%) 0.5 Diabetes 10 (11%) 4 (7.4%) 6 (18%) 0.2 Tracheoesophageal fistula 7 (8.0%) 5 (9.3%) 2 (6.1%) 0.7 Dislipidemia 6 (6.9%) 2 (3.7%) 4 (12%) 0.2 Biomass exposure 6 (6.9%) 5 (9.3%) 1 (3.0%) 0.4 Cancer 6 (6.9%) 2 (3.7%) 4 (12%) 0.2 Undernutrition 4 (4.6%) 3 (5.6%) 1 (3.0%) >0.9 COVID-19 4 (4.6%) 3 (5.6%) 1 (3.0%) >0.9 CKD 3 (3.4%) 2 (3.7%) 1 (3.0%) >0.9 COPD 2 (2.3%) 0 (0%) 2 (6.1%) 0.14 Asthma 2 (2.3%) 0 (0%) 2 (6.1%) 0.14 Heath failure 2 (2.3%) 2 (3.7%) 0 (0%) 0.5 Hypothiroidism 2 (2.3%) 0 (0%) 2 (6.1%) 0.14 Bronchiectasia 1 (1.1%) 0 (0%) 1 (3.0%) 0.4 Rheumatoid arthritis 1 (1.1%) 1 (1.9%) 0 (0%) >0.9 Follow-up Diagnosis-to-surgery 3 43 (22, 114.5) 42.5 (24.3, 113.8) 46 (15, 127) 0.6 Surgery-to-last follow-up 3 243 (144, 333.5) 246 (148.5, 335) 235 (132, 327) >0.9 1 Median (IQR); n (%). 2 Wilcoxon rank sum test; Pearson’s Chi-squared test; Fisher’s exact test. 3 Intervals in days. BMI, body mass index; CKD, chronic kidney disease; COPD, chronic obstructive pulmonary disease; COVID-19, coronavirus disease 2019; SAH, systemic arterial hypertension. Table 2. Etiology and complexity of tracheal stenosis in patients subjected to tracheoplasty Characteristics Overall , N = 87 1 Any complication No , N = 54 1 Yes , N = 33 1 p-value 2 Etiology OIT 78 (90%) 50 (93%) 28 (85%) 0.3 Days with OIT 11.5 (7.0, 17.8) 11.0 (6.0, 19.5) 11.5 (7.0, 15.3) 0.9 Tracheostomy 34 (39%) 19 (35%) 15 (45%) 0.3 Luminal tumor 4 (4.6%) 2 (3.7%) 2 (6.1%) 0.6 Extrinsic tumor 1 (1.1%) 0 (0%) 1 (3.0%) 0.4 Complexity Cotton classification 0.010 Grade II 4 (4.7%) 2 (3.8%) 2 (6.1%) Grade III 64 (74%) 45 (85%) 19 (58%) Grade IV 18 (21%) 6 (11%) 12 (36%) Lumen diameter, mm 5.0 (4.0, 6.0) 5.0 (4.0, 6.0) 5.0 (4.0, 6.0) 0.4 Length, cm 2.0 (1.5, 2.5) 2.0 (1.5, 2.5) 2.0 (2.0, 3.0) 0.5 Other characteristics Complex stenosis 77 (89%) 45 (83%) 32 (97%) 0.082 Multisegmented 8 (9.2%) 2 (3.7%) 6 (18%) 0.049 Malacia 2 (2.3%) 1 (1.9%) 1 (3.0%) >0.9 Granulation tissue 20 (23%) 11 (20%) 9 (27%) 0.5 1 Median (IQR); n (%). 2 Wilcoxon rank sum test; Pearson’s Chi-squared test; Fisher’s exact test. OIT, orotracheal intubation. Table 3. Intervention history and surgical procedures in study participants Characteristics Overall , N = 87 1 Any complication No , N = 54 1 Yes , N = 33 1 p-value 2 Previous management Balloon dilation 61 (70%) 40 (74%) 21 (64%) 0.3 Dilations per patients 1.0 (0.0, 2.0) 1.0 (0.0, 2.0) 1.0 (0.0, 1.0) 0.3 Stent placement 3 (3.4%) 2 (3.7%) 1 (3.0%) >0.9 Ablation with laser 16 (18%) 8 (15%) 8 (24%) 0.3 Montgomery T-tube 4 (4.6%) 2 (3.7%) 2 (6.1%) 0.6 Systemic steroids 27 (31%) 19 (35%) 8 (24%) 0.3 Inhaled steroids 56 (64%) 36 (67%) 20 (61%) 0.6 Previous antibiotic use 26 (30%) 15 (28%) 11 (33%) 0.6 Days of antibiotic use 0.0 (0.0, 3.0) 0.0 (0.0, 2.8) 0.0 (0.0, 4.0) 0.4 Mucolytics 42 (48%) 26 (48%) 16 (48%) >0.9 Type of surgery First intervention 84 (97%) 51 (94%) 33 (100%) 0.3 Re-stenosis 3 (3.4%) 3 (5.6%) 0 (0%) 0.3 Anastomosis characteristics Tracheal 39 (45%) 24 (44%) 15 (45%) >0.9 Cricotracheal 48 (55%) 30 (56%) 18 (55%) >0.9 Resected rings, n 4.0 (3.0, 5.0) 4.0 (3.0, 5.0) 4.0 (4.0, 5.0) 0.6 Perioperative outcomes Blood loss, mL 100.0 (50.0, 150.0) 77.5 (50.0, 100.0) 100.0 (50.0, 200.0) 0.025 Duration of surgery, hours 4.0 (3.5, 4.8) 3.8 (3.4, 4.7) 4.2 (3.9, 5.0) 0.13 Postoperative care Prophylactic antibiotics 70 (80%) 43 (80%) 27 (82%) 0.8 Doses, n 3.0 (1.0, 3.0) 3.0 (1.0, 3.0) 2.0 (1.0, 3.0) 0.3 Therapeutic antibiotics 28 (32%) 8 (15%) 20 (61%) <0.001 Length of antibiotic therapy, days 0.0 (0.0, 4.0) 0.0 (0.0, 0.0) 4.0 (0.0, 8.0) 0.9 Mucolytics 63 (72%) 36 (67%) 27 (82%) 0.12 Other outcomes Hospital stay, days 7.0 (7.0, 9.0) 7.0 (7.0, 7.0) 9.0 (7.0, 13.0) 0.002 1 Median (IQR); n (%). 2 Wilcoxon rank sum test; Pearson’s Chi-squared test; Fisher’s exact test. NSAID, non-steroidal anti-inflammatory drugs. Table 4. Outcomes of patients subjected to tracheoplasty Complications Overall , N = 87 1 Complications per patient, n 2 3.0 (2.0, 4.0) Anastomosis-related complications Restenosis 21 (24%) Dehiscence 7 (8.0%) Systemic complications Granulation tissue 16 (18%) Tracheitis 14 (16%) Permanent tracheostomy 12 (14%) Pneumonia 10 (11%) Dysphonia 8 (9.2%) Wound infection 6 (6.9%) Shock 5 (5.7%) IMV requirement 5 (5.7%) Hemoptysis (non-residual) 4 (4.6%) Hematoma 4 (4.6%) Death 2 (2.3%) Tracheoesophageal fistula 1 (1.1%) Dysphagia 1 (1.1%) Other Reintervention 24 (28%) 1 Median (IQR); n (%). 2 N = 33. IMV, invasive mechanical ventilation. Table 5. Microbiological characteristics of patients subjected to tracheoplasty Characteristics Overall , N = 87 1 Any complication No , N = 54 1 Yes , N = 33 1 p-value 2 Isolate type Bacteria 31 (36%) 9 (17%) 22 (67%) 0.9 Fungi 2 (2.3%) 1 (1.9%) 1 (3.0%) >0.9 NTBM 1 (1.1%) 1 (1.9%) 0 (0%) >0.9 Isolates per patient, n 3 1.0 (0.0, 1.0) 0.0 (0.0, 0.0) 1.0 (0.0, 1.0) <0.001 Specific microbes S. aureus 20 (23%) 4 (7.4%) 16 (48%) 0.9 K. pneumoniae 2 (2.3%) 1 (1.9%) 1 (3.0%) >0.9 E. cloacae 2 (2.3%) 1 (1.9%) 1 (3.0%) >0.9 S. marcensis 1 (1.1%) 0 (0%) 1 (3.0%) 0.4 A. hyrophila 1 (1.1%) 0 (0%) 1 (3.0%) 0.4 H. influenzae 0 (0%) 0 (0%) 0 (0%) S. pneumoniae 0 (0%) 0 (0%) 0 (0%) S. maltophila 0 (0%) 0 (0%) 0 (0%) Other characteristics Drug resistance 11 (13%) 3 (5.6%) 8 (24%) 0.018 1 Median (IQR); n (%). 2 Wilcoxon rank sum test; Pearson’s Chi-squared test; Fisher’s exact test. 3 Of different species. NTBM, non-tuberculous mycobacteria. Table 6. Logistic regression analysis of the factors associated with having any complication in patients subjected to tracheostomy Characteristic OR 1 95% CI 1 p-value q-value 2 S. aureus 11.8 3.74, 45.7 <0.001 <0.001 Any bacterial isolet 10.0 3.75, 29.1 <0.001 <0.001 Complex stenosis 6.40 1.12, 121 0.035 0.454 Multi-segmented stenosis 5.78 1.24, 41.3 0.025 0.418 Drug resistance 5.44 1.44, 26.5 0.012 0.280 Isolets per patient 3.24 1.60, 7.23 <0.001 0.029 Cotton classification 2.80 1.10, 7.72 0.031 0.452 Blood loss 1.01 1.00, 1.01 0.011 0.280 1 OR = Odds Ratio, CI = Confidence Interval. 2 False discovery rate correction for multiple testing. Additional Declarations No competing interests reported. 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debilitating condition with a variety of etiologies, including trauma, prolonged orotracheal intubation (OIT) [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e], tracheostomy [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e], neoplasms, and inflammatory disorders such as systemic vasculitis [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. This narrowing of the airway can severely compromise tracheal patency and lead to respiratory distress, necessitating intervention. Unfortunately, evidence in favor of medical therapies such as the use of systemic steroids in preventing and treating tracheal stenosis is scarce [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. Furthermore, while bronchoscopy dilation offers temporary relief, recurrence is frequent [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e], and complementary interventions are often required [\u003cspan additionalcitationids=\"CR9\" citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e], with most patients with anatomically suitable lesions ultimately requiring definitive tracheoplasty.\u003c/p\u003e \u003cp\u003eDespite surgical technique improvements, the procedure remains associated with significant risk for postoperative complications, particularly at the site of anastomosis, which can lead to dehiscence, restenosis, and infection [\u003cspan additionalcitationids=\"CR12 CR13 CR14 CR15 CR16\" citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. Research has identified several clinical and surgical factors contributing to complications following tracheoplasty [\u003cspan additionalcitationids=\"CR19 CR20 CR21 CR22\" citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]. Some of these predictors include the need for a second tracheoplasty, the presence of diabetes, the extent of resections (especially long-segment), involvement of the laryngotracheal area, younger age, and a history of prior tracheostomy [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThese findings emphasize the multifaceted nature of postoperative risk and illustrate the critical importance of thorough preoperative evaluations, which should include careful patient selection and meticulous surgical planning. However, while much attention has been given to patient- and procedure-related variables, the influence of microbiological factors on tracheoplasty results has not been extensively studied. The colonization of the airway by pathogenic bacteria can hinder mucosal healing and incite local inflammatory responses, elevating the risk of postoperative adverse outcomes. These effects are particularly pertinent in patients with a history of airway stenting, tracheostomy, or repeated endoscopic interventions [\u003cspan additionalcitationids=\"CR25 CR26 CR27 CR28 CR29 CR30 CR31\" citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eHere, we sought to evaluate both clinical and microbiological predictors of adverse outcomes following tracheoplasty performed for traumatic or tumoral stenosis.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003eStudy Design and Population\u003c/p\u003e\n\u003cp\u003eWe conducted a retrospective cohort study at a national reference center for airway disorders. The objective was to evaluate clinical and microbiological predictors of adverse outcomes following tracheoplasty. The study included all consecutive adult patients (aged \u0026ge;18 years) who underwent tracheal resection and anastomosis between April 1, 2023, and March 31, 2025. Despite clinical registries of potential participants being available in the electronic database since 2019, this period was chosen to ensure uniformity in surgical and perioperative protocols, avoiding the effects of resource reallocation during the COVID-19 outbreak.\u003c/p\u003e\n\u003cp\u003ePatients were eligible for inclusion if they had a diagnosis of tracheal stenosis due to traumatic injury (OIT, tracheostomy) or tumoral obstruction. The diagnosis and surgical indication were established via multidisciplinary evaluation that included thoracic surgeons, otorhinolaryngologists, pulmonologists, anesthesiologists, and infectious diseases specialists, with preoperative confirmation through computed tomography (CT) and flexible bronchoscopy.\u003c/p\u003e\n\u003cp\u003eExclusion criteria included bronchial involvement, systemic vasculitis or other inflammatory disorders, congenital airway anomalies, idiopathic stenosis, active respiratory infections at the time of surgery, or incomplete medical records. We also excluded patients who had undergone prior tracheoplasty at other institutions to ensure uniformity in surgical technique and perioperative care.\u003c/p\u003e\n\u003cp\u003ePostoperative Care Protocol for Tracheoplasty Patients\u003c/p\u003e\n\u003cp\u003eAt our institution, most patients undergoing tracheoplasty are admitted electively following a comprehensive preoperative protocol, which includes multidisciplinary evaluations by internal medicine, nutrition, cardiology, neurology, and psychiatry. This workup serves to exclude patients at high risk of postoperative complications and prevent seizures or psychological inability to maintain cervical flexion for the required postoperative surveillance period. During the preoperative assessment, patients undergo both diagnostic and therapeutic bronchoscopy, along with imaging studies including CT with airway reconstruction to facilitate surgical planning.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eImmediately after surgery, patients are transferred to the postoperative care unit located adjacent to the operating rooms. This unit functions as a critical care area equipped to provide advanced intensive care interventions, including extracorporeal membrane oxygenation (ECMO) if needed. All patients are extubated in the operating room. If extubation is not feasible, or if a high risk of complications is anticipated by the surgeon (history of vocal cord paralysis, large segment to be resected, among others), a protective tracheostomy is performed distal to the anastomotic site. Patients with tracheostomy below the site of stenosis who did not complete a decannulation protocol in the preoperative period are not excluded from the procedure and keep their cannula in place after the surgery.\u003c/p\u003e\n\u003cp\u003ePostoperative care includes oxygen therapy via a humidified face mask, non-opioid analgesia to minimize nausea, voice rest, and assisted cervical flexion. Some patients receive prophylactic antibiotics to minimize wound infection risk at the discretion of the attending thoracic surgeon. Any of the postoperative interventions may be modified or omitted as considered by the surgical team.\u003c/p\u003e\n\u003cp\u003eData Collection\u003c/p\u003e\n\u003cp\u003eData were extracted from electronic clinical records using a structured abstraction form developed by the study team. Demographic information included age, sex, and body mass index (BMI). Comorbidities were recorded based on medical history and included diabetes, systemic arterial hypertension (SAH), chronic respiratory disease, obesity (BMI \u0026ge;30 kg/m\u0026sup2;), psychiatric illness, and neurologic impairment (e.g., stroke, traumatic brain injury). We also recorded behavioral risk factors such as tobacco use.\u003c/p\u003e\n\u003cp\u003eStenosis characteristics were documented based on bronchoscopy and surgical findings. These included minimum luminal diameter (in millimeters), length of the stenotic segment (in centimeters), anatomical location (upper, middle, or lower third of the trachea), complexity (classified as simple or complex based on mucosal integrity and presence of granulation tissue), and multisegmented involvement (defined as stenosis affecting more than one contiguous tracheal region). The etiology of stenosis was classified as traumatic (post-intubation or tracheostomy) or tumoral.\u003c/p\u003e\n\u003cp\u003eSurgical variables included the number of tracheal rings resected, the total duration of surgery (in minutes), and estimated intraoperative blood loss. All tracheoplasties were performed by the institution\u0026rsquo;s thoracic surgical and otorhinolaryngology teams using standardized techniques involving circumferential resection and tension-free end-to-end anastomosis. Airway caliber was assessed intraoperatively using flexible bronchoscopy, and intraoperative complications were recorded when applicable.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAs part of the surgical assessment, we also reviewed pathological reports from tracheal specimens obtained during resection. Histopathological variables of interest were extracted from formal pathology reports and categorized as present or absent. All specimens were evaluated by board-certified pathologists with expertise in pulmonary and airway pathology, using hematoxylin and eosin staining and standard diagnostic criteria.\u003c/p\u003e\n\u003cp\u003eMicrobiological Assessment\u003c/p\u003e\n\u003cp\u003eAssessment of airway colonization was based on respiratory specimens collected from each patient within 30 days before surgery or the first 48 hours postoperatively, provided there was no clinical evidence of active infection (i.e., fever, elevated inflammatory markers, or purulent secretions). Samples included oropharyngeal/nasopharyngeal swab specimens, sputum, tracheal aspirates, or bronchoalveolar lavage fluid, depending on patient status and clinical indication. All samples were processed in the hospital\u0026rsquo;s microbiology laboratory using conventional bacterial cultures and a multiplex polymerase chain reaction (PCR) panel designed to detect common respiratory pathogens. Viral and fungal identification were also recorded if detected. Colonization was defined as the presence of microbial growth or a positive PCR result in the absence of systemic or localized signs of infection. Patients were categorized based on colonization status and the specific pathogen identified. Repeated cultures were obtained during hospitalization only if new clinical symptoms developed.\u003c/p\u003e\n\u003cp\u003eAntibiotic Exposure\u003c/p\u003e\n\u003cp\u003ePostoperative antibiotic prophylaxis was defined as the administration of at least one dose of systemic antibiotics with prophylactic intent (typically 30 minutes before the procedure or within 24 hours postoperatively). In most cases, the use of antibiotics was not tailored to microbiological findings. Patients were stratified according to whether they received prophylactic antibiotics, and subsequent therapeutic antibiotic use was recorded when indicated for new or worsening clinical signs of active infection.\u003c/p\u003e\n\u003cp\u003eOutcomes\u003c/p\u003e\n\u003cp\u003eThe primary outcome was the occurrence of at least one postoperative complication at any time during the postoperative follow-up. Specific complications at the anastomosis site or systemic complications were also analyzed individually. These included one or more of the following events: anastomotic dehiscence or restenosis, surgical site infection, tracheitis, hematoma, non-residual hemoptysis, hospital-acquired pneumonia, need for invasive mechanical ventilation (IMV), in-hospital mortality, and long-term sequela, like tracheoesophageal fistula, dysphonia, and dysphagia. The need for airway instrumentation by bronchoscopy or surgical reintervention after the primary procedure was also recorded as a response variable. Complications were adjudicated by independent clinicians not involved in the initial surgery. Other variables of interest included the length of postoperative hospitalization and the need for escalation of antibiotic therapy.\u003c/p\u003e\n\u003cp\u003eStatistical Analysis\u003c/p\u003e\n\u003cp\u003eDescriptive statistics were used to summarize patient demographics, clinical variables, surgical characteristics, and outcomes. Categorical variables were reported as frequencies and percentages, and continuous variables were expressed as medians with interquartile ranges (IQR). Comparisons between groups were performed using Pearson\u0026rsquo;s Chi-squared test or Fisher\u0026rsquo;s exact test for categorical data and Wilcoxon rank sum test for continuous data.\u003c/p\u003e\n\u003cp\u003eLogistic regression for key clinical, surgical, and microbiological factors was used to identify predictors of complications after tracheoplasty. Given the exploratory nature of the study and the limited sample size, multivariate models were not constructed to minimize the risk of overfitting. Results were reported as odds ratios (OR) with 95% confidence intervals (CI). To account for multiple testing, false discovery rate (FDR) correction was applied to univariate logistic regression models using the Benjamini\u0026ndash;Hochberg method, and q-values were calculated. While results were primarily interpreted as suggestive of association based on unadjusted p-values \u0026lt; 0.05 to identify potential predictors of outcomes, q-values (\u0026lt; 0.1) were reported to highlight independent predictors with robust association.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAll statistical analyses were performed using R software (version 4.1.2, R Foundation for Statistical Computing, Vienna, Austria) and GraphPad Prism (version 9.5, La Jolla, CA, USA). A two-sided p-value of \u0026lt;0.05 was considered statistically significant. Detailed test results are presented in the relevant tables and figure legends.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003ePatient Characteristics\u003c/p\u003e\n\u003cp\u003eA total of 99 patients who underwent tracheoplasty since 2019 were identified in the electronic database of our center. Of these, 87 patients were eligible for the analysis as they received surgery within the established study period. Their demographic characteristics are summarized in \u003cstrong\u003eTable 1\u003c/strong\u003e. The median age was 32 years with a predominance of males. Common comorbidities included SAH (17%), diabetes (11%), and smoking history (39%). Neurological impairment secondary to trauma or cerebrovascular events was present in 41%, and 14% had documented psychiatric disorders. Regarding nutritional status, 31% were overweight, 11% were obese, and 4.6% presented with undernutrition.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe predominant etiology of tracheal stenosis was traumatic, related to prolonged OIT in 90% of cases. The median duration of intubation was 11.5 days. Nearly 89% of patients had complex stenosis, and 9.2% had multisegmented involvement. According to the Cotton classification, 95% had grade III-IV stenoses, with a median minimum luminal diameter of 5 mm and a stenosis length of 2.0 cm (\u003cstrong\u003eTable 2\u003c/strong\u003e).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eIntervention history and characteristics of tracheoplasty procedures performed in study participants are summarized in \u003cstrong\u003eTable 3\u003c/strong\u003e. Preoperative management frequently involved endoscopic interventions. Balloon dilation was performed in 70% of patients (median of one procedure per patient), and 18% underwent laser ablation. Inhaled corticosteroids were prescribed at least once at any time during the preoperative period in 64%, and systemic corticosteroids in 31%. Only 3.4% had prior stent placement, and 4.6% had a Montgomery T-tube. A total of 26 patients (30%) had received antibiotics before surgery to treat documented respiratory infections. These infections occurred outside the 30-day preoperative window used to define airway colonization and were therefore not considered in the assessment of perioperative microbiological status. The median duration of antibiotic exposure before surgery in these cases was three days (IQR: 0\u0026ndash;4). Most patients (97%) underwent their first tracheal resection (primary tracheoplasty), with a median of four tracheal rings resected and a surgical duration of 4.0 hours. The median intraoperative blood loss was 100 mL, and most anastomoses were cricotracheal (55%).\u003c/p\u003e\n\u003cp\u003eDifferences Across Groups According to Outcomes\u003c/p\u003e\n\u003cp\u003eWhen we analyze the full range of possible complications, 33 patients experienced at least one adverse outcome after surgery. The median number of complications per affected patient was three. The most frequent complications are described in \u003cstrong\u003eTable 4\u003c/strong\u003e. Only 23 patients (26%) had a direct compromise of the anastomotic site (dehiscence and/or restenosis). Two deaths occurred during the postoperative period, one related to hospital-acquired pneumonia and sepsis, the other due to anastomosis dehiscence.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003ePatients were grouped according to the presence of at least one systemic or anastomosis site complication, including the requirement of any reintervention procedure during follow-up. Although re-intervention procedures are not per se a complication, they reflect subsequent use of resources due to postoperative morbidity. As such, several distinctions were evident between patient groups. Patients who developed complications were significantly more likely to have complex, multisegmented stenosis (\u003cstrong\u003eTable 2\u003c/strong\u003e) and experienced higher intraoperative blood loss (\u003cstrong\u003eTable 3\u003c/strong\u003e). While demographic and nutritional profiles were similar between groups, there were higher but not statistically significant frequencies of diabetes and SAH among those who experienced complications (\u003cstrong\u003eTable 1\u003c/strong\u003e). No significant differences were noted in other comorbidities, prior interventions, histopathological features (\u003cstrong\u003eTable S1\u003c/strong\u003e), or laboratory parameters (\u003cstrong\u003eTable S2\u003c/strong\u003e).\u003c/p\u003e\n\u003cp\u003eMicrobiologically, bacterial colonization was substantially more prevalent among patients with complications. The most frequent isolates are summarized in \u003cstrong\u003eTable 5\u003c/strong\u003e. \u003cem\u003eS. aureus\u003c/em\u003e was the most prevalent microorganism, identified with higher frequency in patients with complications compared to those without adverse surgical outcomes. Interestingly, viruses were isolated in 14% of participants but showed no different distribution among groups according to outcomes.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003ePredictors of Postoperative Complications\u003c/p\u003e\n\u003cp\u003eA univariate logistic regression analysis was conducted to identify factors associated with postoperative complications (\u003cstrong\u003eTable 6\u003c/strong\u003e). Colonization by \u003cem\u003eS. aureus\u003c/em\u003e emerged as the most powerful predictor, followed by the presence of any bacterial isolate and the number of isolates per patient. Drug resistance also significantly increased the odds of complications. Anatomical and procedural characteristics were also predictive but not independent risk factors, as they reached no statistical significance after correction for multiple comparisons. Multisegmented stenosis was associated with a fivefold increase in complication risk, while complex stenosis showed a similar effect. Higher intraoperative blood loss was modestly predictive.\u003c/p\u003e\n\u003cp\u003eFurther analysis of individual postoperative complications revealed distinct and clinically relevant associations (\u003cstrong\u003eTable S3\u003c/strong\u003e). To ensure statistical robustness, logistic regression was performed only for complications occurring in approximately 10% or more of the study population. Accordingly, less frequent events were excluded from modeling due to insufficient event count. Among the complications with adequate frequency, \u003cem\u003eS. aureus\u003c/em\u003e colonization emerged as a central predictor significantly associated with tracheitis, anastomotic dehiscence, need for permanent tracheostomy, and surgical/bronchoscopy reintervention. Notably, it was an independent risk factor for hospital-acquired pneumonia. In addition to \u003cem\u003eS. aureus\u003c/em\u003e, a higher number of isolates per patient and the presence of any bacterial isolate were consistently associated with multiple complications, particularly pneumonia, tracheitis, and permanent tracheostomy. Blood loss during surgery was relevant for reintervention, restenosis, development of granulation tissue, tracheitis, dysphonia, and was only independently associated with pneumonia.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTracheitis was independently associated not only with microbial factors but also with host factors, including epilepsy, elevated gamma-glutamyl transferase (GGT), and prothrombin time. Similarly, dehiscence showed strong associations with drug-resistant colonization and elevated GGT, suggesting a complex interplay between microbial virulence and systemic inflammation. Pneumonia, one of the most severe complications, was associated with a broad array of factors beyond microbiological predictors. These included age, diabetes, preoperative inhaled steroid use, prolonged antibiotic exposure before surgery, and the use of mucolytics. Restenosis correlated with the Cotton classification of the initial stenosis. Finally, the need for reintervention closely followed the distribution of airway infections and dehiscence events.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAlthough in-hospital mortality was low (2.3%), both patients who died had complex stenosis, diabetes, and \u003cem\u003eS. aureus\u003c/em\u003e colonization.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eRole of Antibiotics\u003c/p\u003e\n\u003cp\u003eProphylactic antibiotic administration was applied in 80% of patients at the discretion of the surgical team, typically for three days (IQR: 1\u0026ndash;3). No differences in the proportion of patients who developed any complication were observed between patients according to antibiotic prophylaxis exposure. In contrast to prophylaxis, therapeutic antibiotics were only prescribed when infection was clinically diagnosed, defined by the combination of new or worsening respiratory symptoms, elevated inflammatory markers, and the identification of pathogens not previously isolated. This approach was necessary in 61% of patients with complications, compared to only 15% of those without (p \u0026lt; 0.001; \u003cstrong\u003eTable 3\u003c/strong\u003e). The most used antibiotics were ceftriaxone, piperacillin-tazobactam, and amoxicillin-clavulanate.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eTracheoplasty remains a technically demanding yet potentially curative intervention for patients with high-grade tracheal stenosis [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. Despite advances in surgical technique and perioperative care, the procedure continues to be associated with significant postoperative morbidity [\u003cspan additionalcitationids=\"CR12 CR13 CR14 CR15 CR16\" citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. Historically, attention has focused primarily on anatomical and procedural variables, such as the degree and length of stenosis, its proximity to the glottis, and the complexity of resection, as well as host comorbidities in predicting outcomes [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. However, relatively little has been published on the contribution of airway microbiology as a potential determinant of surgical complications.\u003c/p\u003e \u003cp\u003eOur study represents one of the first systematic attempts to simultaneously assess clinical, anatomical, surgical, and microbiological predictors of adverse outcomes following tracheoplasty. Many of our findings are consistent with prior reports that have identified age, diabetes, and the presence of systemic inflammatory conditions as significant determinants of postoperative outcomes [\u003cspan additionalcitationids=\"CR19 CR20\" citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]. Similarly, anatomical variables, including etiology of stenosis, glottic involvement, vocal cord dysfunction, multisegmental disease, and prior reconstructive attempts, have been associated with increased surgical risk. These data have informed the establishment of preoperative exclusion criteria in many high-volume centers, where patients with lesions longer than 4 cm, glottic proximity, or a history of failed reconstruction may be deemed unsuitable for resection [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. In our study, we observed that higher Cotton classification, multisegmental involvement, and complex stenoses were significantly associated with a greater likelihood of complications, reinforcing the prognostic value of these structural features.\u003c/p\u003e \u003cp\u003eNonetheless, our findings also shed light on additional contributors that may explain the heterogeneity of outcomes reported across centers. Compared to previous reports from high-resource institutions [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e], we observed a higher overall complication rate, although most adverse outcomes were mild, and mortality remained similarly low. This discrepancy is consistent with data from public institutions in low- and middle-income settings, where delayed referral, limited access to diagnostic modalities, and resource constraints may contribute to worse outcomes [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e, \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]. Our hospital is a publicly funded national referral center that primarily serves uninsured and socioeconomically disadvantaged populations. Patients are frequently referred late in the disease course, often with poorly controlled comorbidities, previous failed interventions, or without adequate preoperative optimization. As others have noted, socioeconomic and structural healthcare disparities significantly influence outcomes in major airway surgery [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eBeyond confirming known clinical predictors, we provide novel insights into perioperative variables not routinely assessed in previous studies. Notably, intraoperative blood loss emerged as a consistent potential predictor of multiple adverse events, including restenosis, granulation tissue formation, tracheitis, pneumonia, dysphonia, and the need for subsequent reintervention at any time during follow-up. While this parameter is often overlooked in outcome models, our findings suggest that greater intraoperative hemorrhage may reflect more technically challenging resections or compromised vascular integrity at the anastomotic site, factors that could adversely affect healing and predispose to infection or structural failure.\u003c/p\u003e \u003cp\u003ePerhaps the most striking and clinically actionable finding of our study is the robust association between airway colonization with \u003cem\u003eS. aureus\u003c/em\u003e and postoperative complications. Although prior studies have hinted at the role of infection in anastomotic failure or restenosis [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e], few have systematically evaluated preoperative colonization as a risk marker. In this regard, our study expands the scope of risk assessment by incorporating a detailed description of the microbial spectrum affecting this population, including different microorganism species. Interestingly, the detection of respiratory viruses, though relatively frequent, did not correlate with an increased risk of postoperative complications. This suggests that in the absence of clinical signs of acute infection, incidental viral identification may not warrant deferral of surgery [\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eIn contrast, bacterial colonization, especially with \u003cem\u003eS. aureus\u003c/em\u003e, was strongly associated with virtually every major complication. These associations persisted even after adjusting for multiple comparisons, highlighting the potential role of microbial pathogenicity and host-microbe interactions in surgical outcomes. Additionally, polymicrobial colonization and the presence of drug-resistant organisms further increased the risk of specific complications. Nouraei SA, et al., in 2006, demonstrated that colonization of airway stents with \u003cem\u003eS. aureus\u003c/em\u003e and \u003cem\u003eP. aeruginosa\u003c/em\u003e was strongly associated with persistent granulation of the airway, a common cause of failure after tracheal reconstruction [\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e]. They suggested that antibiotic coverage of these microorganisms must be among the preventive measures for patients candidates for laryngotracheoplasty.\u003c/p\u003e \u003cp\u003eThe potential mechanistic basis for our most remarkable observation lies in several \u003cem\u003eS. aureus\u003c/em\u003e virulence factors that alter the integrity and function of the airway epithelium. As such, \u003cem\u003ein vitro\u003c/em\u003e models using air-liquid interface cultures of airway epithelial cells have uncovered soluble factors secreted by \u003cem\u003eS. aureus\u003c/em\u003e that exert a direct disrupting effect on tight junction proteins, such as the alpha hemolysin (Hla) [\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e, \u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e]. In addition, \u003cem\u003eS. aureus\u003c/em\u003e superantigens and enterotoxins induce a persistent local inflammatory reaction in the airway epithelium, which disrupts the integrity of the barrier, hinders its re-epithelialization, and promotes infection. Emerging evidence exists on the specific induction of a T2 inflammatory profile by these bacterial products in the airways that also promotes tissue damage and fibrosis, as observed in patients with chronic sinusitis, allergic rhinitis, and asthma [\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e, \u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eOf great interest is the observation made by Yamada Y, et al., 2001, who identified a relationship between the development of acquired airway stenosis and tracheal infection by a methicillin-resistant \u003cem\u003eS. aureus\u003c/em\u003e strain producing the epidermal cell differentiation inhibitor (EDIN) toxin in two children [\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e]. EDIN belongs to a class of exotoxins capable of disrupting Rho GTPase activity, thereby impairing epithelial cell migration and promoting endothelial barrier dysfunction [\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e]. While our study did not directly assess EDIN expression, the magnitude of association between \u003cem\u003eS. aureus\u003c/em\u003e colonization and key healing-related complications in our cohort raises the possibility that similar mechanisms may be at play in adult tracheal surgery. These data warrant further microbiological and translational investigation to characterize virulence profiles of \u003cem\u003eS. aureus\u003c/em\u003e isolates in airway-colonized patients.\u003c/p\u003e \u003cp\u003ePerhaps more importantly, the consistent association between microbiological factors and adverse clinical outcomes might prompt some surgical teams to adopt perioperative antibiotic prophylaxis as a routine strategy to mitigate complications. However, our findings challenge this widespread yet largely unexamined practice. In our cohort, prophylaxis was not associated with a lower incidence of any clinical outcome, including infection-related events. These results support the need to re-evaluate current perioperative antibiotic protocols and explore microbiology-guided strategies instead of empirical use in airway surgery.\u003c/p\u003e"},{"header":"Conclusions","content":"\u003cp\u003eOur study highlights the importance of adopting a multidimensional approach to risk assessment in tracheoplasty. Our results reaffirm the significance of established risk factors, such as comorbidities and the complexity of stenosis. More importantly, we identified bacterial colonization, especially by \u003cem\u003eS. aureus\u003c/em\u003e, as a robust, independent predictor of postoperative complications. Interestingly, despite the widespread prescription of protocolized postoperative antibiotic prophylaxis by surgical teams, our findings indicated no significant correlation between this practice and a reduction in adverse events. These results suggest that a more effective and rational approach to improving surgical outcomes in tracheal reconstruction may lie in the preoperative identification of airway colonization, coupled with the development and application of targeted antimicrobial strategies, rather than relying solely on routine, non-selective antibiotic prophylaxis.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eBMI, body mass index; CI, confidence intervals; COVID-19, coronavirus disease 2019; CT, computed tomography; \u0026nbsp;ECMO, extracorporeal membrane oxygenation; EDIN, epidermal cell differentiation inhibitor; FDR, false discovery rate; GGT, gamma-glutamyl transferase; IMV, invasive mechanical ventilation; IQR, interquartile range; OIT, orotracheal intubation; OR, odds ratio; PCR, polymerase chain reaction; SAH, systemic arterial hypertension.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study was conducted in accordance with the Declaration of Helsinki and was approved by the Institutional Review Board and Ethics Committee of the Instituto Nacional de Enfermedades Respiratorias \u0026ldquo;Ismael Cos\u0026iacute;o Villegas\u0026rdquo; (INER), Mexico City. All study participants provided written informed consent. Given the retrospective observational design and the use of anonymized data, trial registration was not required.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable. This study did not include any identifiable individual patient data.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets generated and/or analyzed during the current study are available from the corresponding author on reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026acute; contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eJACP, FBPO, JDCA, CMHC, MCL, GHS, conceived and designed the study.\u003c/p\u003e\n\u003cp\u003eJACP, AYGT, IMB, MAIG, JFAV, GLV, ATG, SRB, KSG, AAG, collected and curated the data.\u003c/p\u003e\n\u003cp\u003eJACP, MCL performed the statistical analysis.\u003c/p\u003e\n\u003cp\u003eJACP, FBPO, MAIG, JLCA, MCL, GHS interpreted the data.\u003c/p\u003e\n\u003cp\u003eJACP, MAIG, JLCA, MCL, GHS drafted the manuscript.\u003c/p\u003e\n\u003cp\u003eAll authors critically revised the manuscript for important intellectual content and approved the final version of the manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNone.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eWain JC: \u003cstrong\u003ePostintubation tracheal stenosis\u003c/strong\u003e. \u003cem\u003eChest Surg Clin N Am \u003c/em\u003e2003, \u003cstrong\u003e13\u003c/strong\u003e(2):231-246.\u003c/li\u003e\n\u003cli\u003eKettunen WW, Helmer SD, Haan JM: \u003cstrong\u003eIncidence of overall complications and symptomatic 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Participant characteristics\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eCharacteristics\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eOverall\u003c/strong\u003e, N = 87\u003cem\u003e\u003csup\u003e1\u003c/sup\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eAny complication\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eNo\u003c/strong\u003e, N = 54\u003cem\u003e\u003csup\u003e1\u003c/sup\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eYes\u003c/strong\u003e, N = 33\u003cem\u003e\u003csup\u003e1\u003c/sup\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ep-value\u003c/strong\u003e\u003cem\u003e\u003csup\u003e2\u003c/sup\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eDemographics\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eAge, years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e32 (22.5, 47)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e34 (22, 43.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e30 (23, 50)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026gt;0.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e58 (67%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e38 (70%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e20 (61%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eBMI, kg/m\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e24 (22, 26.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e23.3 (21.8, 26.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e24.8 (22.7, 27.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.14\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eComorbidities\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNeurological sequela\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e36 (41%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e24 (44%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e12 (36%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eSmoking\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e34 (39%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e24 (44%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e10 (30%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eOverweight\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e27 (31%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e16 (30%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e11 (33%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eSAH\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e15 (17%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e7 (13%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e8 (24%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eEpilepsy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e12 (14%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e5 (9.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e7 (21%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003ePsychiatric disorder\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e12 (14%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e8 (15%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e4 (12%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026gt;0.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eObesity\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e10 (11%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e5 (9.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e5 (15%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eDiabetes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e10 (11%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e4 (7.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e6 (18%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eTracheoesophageal fistula\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e7 (8.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e5 (9.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2 (6.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eDislipidemia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e6 (6.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2 (3.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e4 (12%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eBiomass exposure\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e6 (6.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e5 (9.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1 (3.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eCancer\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e6 (6.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2 (3.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e4 (12%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eUndernutrition\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e4 (4.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e3 (5.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1 (3.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026gt;0.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eCOVID-19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e4 (4.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e3 (5.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1 (3.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026gt;0.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eCKD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e3 (3.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2 (3.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1 (3.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026gt;0.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eCOPD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2 (2.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0 (0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2 (6.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.14\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eAsthma\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2 (2.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0 (0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2 (6.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.14\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eHeath failure\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2 (2.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2 (3.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0 (0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eHypothiroidism\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2 (2.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0 (0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2 (6.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.14\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eBronchiectasia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1 (1.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0 (0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1 (3.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eRheumatoid arthritis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1 (1.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1 (1.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0 (0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026gt;0.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eFollow-up\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eDiagnosis-to-surgery\u003cem\u003e\u003csup\u003e3\u003c/sup\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e43 (22, 114.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e42.5 (24.3, 113.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e46 (15, 127)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eSurgery-to-last follow-up\u003cem\u003e\u003csup\u003e3\u003c/sup\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e243 (144, 333.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e246 (148.5, 335)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e235 (132, 327)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026gt;0.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\"\u003e\n \u003cp\u003e\u003cem\u003e\u003csup\u003e1\u0026nbsp;\u003c/sup\u003e\u003c/em\u003eMedian (IQR); n (%).\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u003csup\u003e2\u0026nbsp;\u003c/sup\u003e\u003c/em\u003eWilcoxon rank sum test; Pearson\u0026rsquo;s Chi-squared test; Fisher\u0026rsquo;s exact test.\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u003csup\u003e3\u0026nbsp;\u003c/sup\u003e\u003c/em\u003eIntervals in days.\u003c/p\u003e\n \u003cp\u003eBMI, body mass index; CKD, chronic kidney disease; COPD, chronic obstructive pulmonary disease; COVID-19, coronavirus disease 2019; SAH, systemic arterial hypertension.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"100%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTable 2. Etiology and complexity of tracheal stenosis in patients subjected to tracheoplasty\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 25px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCharacteristics\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 20px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOverall\u003c/strong\u003e, N = 87\u003cem\u003e\u003csup\u003e1\u003c/sup\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 53px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAny complication\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 20px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNo\u003c/strong\u003e, N = 54\u003cem\u003e\u003csup\u003e1\u003c/sup\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eYes\u003c/strong\u003e, N = 33\u003cem\u003e\u003csup\u003e1\u003c/sup\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ep-value\u003c/strong\u003e\u003cem\u003e\u003csup\u003e2\u003c/sup\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 25px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEtiology\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 25px;\"\u003e\n \u003cp\u003eOIT\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20px;\"\u003e\n \u003cp\u003e78 (90%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20px;\"\u003e\n \u003cp\u003e50 (93%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20px;\"\u003e\n \u003cp\u003e28 (85%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e0.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 25px;\"\u003e\n \u003cp\u003eDays with OIT\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20px;\"\u003e\n \u003cp\u003e11.5 (7.0, 17.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20px;\"\u003e\n \u003cp\u003e11.0 (6.0, 19.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20px;\"\u003e\n \u003cp\u003e11.5 (7.0, 15.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e0.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 25px;\"\u003e\n \u003cp\u003eTracheostomy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20px;\"\u003e\n \u003cp\u003e34 (39%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20px;\"\u003e\n \u003cp\u003e19 (35%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20px;\"\u003e\n \u003cp\u003e15 (45%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e0.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 25px;\"\u003e\n \u003cp\u003eLuminal tumor\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20px;\"\u003e\n \u003cp\u003e4 (4.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20px;\"\u003e\n \u003cp\u003e2 (3.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20px;\"\u003e\n \u003cp\u003e2 (6.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e0.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 25px;\"\u003e\n \u003cp\u003eExtrinsic tumor\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20px;\"\u003e\n \u003cp\u003e1 (1.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20px;\"\u003e\n \u003cp\u003e0 (0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20px;\"\u003e\n \u003cp\u003e1 (3.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e0.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 25px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eComplexity\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 25px;\"\u003e\n \u003cp\u003eCotton classification\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e0.010\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 25px;\"\u003e\n \u003cp\u003eGrade II\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20px;\"\u003e\n \u003cp\u003e4 (4.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20px;\"\u003e\n \u003cp\u003e2 (3.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20px;\"\u003e\n \u003cp\u003e2 (6.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 25px;\"\u003e\n \u003cp\u003eGrade III\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20px;\"\u003e\n \u003cp\u003e64 (74%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20px;\"\u003e\n \u003cp\u003e45 (85%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20px;\"\u003e\n \u003cp\u003e19 (58%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 25px;\"\u003e\n \u003cp\u003eGrade IV\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20px;\"\u003e\n \u003cp\u003e18 (21%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20px;\"\u003e\n \u003cp\u003e6 (11%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20px;\"\u003e\n \u003cp\u003e12 (36%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 25px;\"\u003e\n \u003cp\u003eLumen diameter, mm\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20px;\"\u003e\n \u003cp\u003e5.0 (4.0, 6.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20px;\"\u003e\n \u003cp\u003e5.0 (4.0, 6.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20px;\"\u003e\n \u003cp\u003e5.0 (4.0, 6.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e0.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 25px;\"\u003e\n \u003cp\u003eLength, cm\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20px;\"\u003e\n \u003cp\u003e2.0 (1.5, 2.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20px;\"\u003e\n \u003cp\u003e2.0 (1.5, 2.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20px;\"\u003e\n \u003cp\u003e2.0 (2.0, 3.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e0.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 25px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOther characteristics\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 25px;\"\u003e\n \u003cp\u003eComplex stenosis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20px;\"\u003e\n \u003cp\u003e77 (89%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20px;\"\u003e\n \u003cp\u003e45 (83%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20px;\"\u003e\n \u003cp\u003e32 (97%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e0.082\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 25px;\"\u003e\n \u003cp\u003eMultisegmented\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20px;\"\u003e\n \u003cp\u003e8 (9.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20px;\"\u003e\n \u003cp\u003e2 (3.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20px;\"\u003e\n \u003cp\u003e6 (18%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e0.049\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 25px;\"\u003e\n \u003cp\u003eMalacia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20px;\"\u003e\n \u003cp\u003e2 (2.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20px;\"\u003e\n \u003cp\u003e1 (1.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20px;\"\u003e\n \u003cp\u003e1 (3.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e\u0026gt;0.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 25px;\"\u003e\n \u003cp\u003eGranulation tissue\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20px;\"\u003e\n \u003cp\u003e20 (23%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20px;\"\u003e\n \u003cp\u003e11 (20%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20px;\"\u003e\n \u003cp\u003e9 (27%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e0.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u003csup\u003e1\u0026nbsp;\u003c/sup\u003e\u003c/em\u003eMedian (IQR); n (%).\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u003csup\u003e2\u0026nbsp;\u003c/sup\u003e\u003c/em\u003eWilcoxon rank sum test; Pearson\u0026rsquo;s Chi-squared test; Fisher\u0026rsquo;s exact test.\u003c/p\u003e\n \u003cp\u003eOIT, orotracheal intubation.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eTable 3. Intervention history and surgical procedures in study participants\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eCharacteristics\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eOverall\u003c/strong\u003e, N = 87\u003cem\u003e\u003csup\u003e1\u003c/sup\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eAny complication\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eNo\u003c/strong\u003e, N = 54\u003cem\u003e\u003csup\u003e1\u003c/sup\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eYes\u003c/strong\u003e, N = 33\u003cem\u003e\u003csup\u003e1\u003c/sup\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ep-value\u003c/strong\u003e\u003cem\u003e\u003csup\u003e2\u003c/sup\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ePrevious management\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eBalloon dilation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e61 (70%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e40 (74%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e21 (64%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eDilations per patients\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1.0 (0.0, 2.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1.0 (0.0, 2.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1.0 (0.0, 1.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eStent placement\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e3 (3.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2 (3.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1 (3.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026gt;0.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eAblation with laser\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e16 (18%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e8 (15%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e8 (24%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eMontgomery T-tube\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e4 (4.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2 (3.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2 (6.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eSystemic steroids\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e27 (31%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e19 (35%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e8 (24%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eInhaled steroids\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e56 (64%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e36 (67%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e20 (61%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003ePrevious antibiotic use\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e26 (30%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e15 (28%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e11 (33%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eDays of antibiotic use\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.0 (0.0, 3.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.0 (0.0, 2.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.0 (0.0, 4.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eMucolytics\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e42 (48%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e26 (48%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e16 (48%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026gt;0.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eType of surgery\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eFirst intervention\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e84 (97%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e51 (94%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e33 (100%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eRe-stenosis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e3 (3.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e3 (5.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0 (0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eAnastomosis characteristics\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eTracheal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e39 (45%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e24 (44%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e15 (45%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026gt;0.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eCricotracheal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e48 (55%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e30 (56%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e18 (55%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026gt;0.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eResected rings, n\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e4.0 (3.0, 5.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e4.0 (3.0, 5.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e4.0 (4.0, 5.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ePerioperative outcomes\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eBlood loss, mL\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e100.0 (50.0, 150.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e77.5 (50.0, 100.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e100.0 (50.0, 200.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.025\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eDuration of surgery, hours\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e4.0 (3.5, 4.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e3.8 (3.4, 4.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e4.2 (3.9, 5.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.13\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ePostoperative care\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eProphylactic antibiotics\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e70 (80%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e43 (80%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e27 (82%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eDoses, n\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e3.0 (1.0, 3.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e3.0 (1.0, 3.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2.0 (1.0, 3.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eTherapeutic antibiotics\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e28 (32%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e8 (15%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e20 (61%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eLength of antibiotic therapy, days\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.0 (0.0, 4.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.0 (0.0, 0.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e4.0 (0.0, 8.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNSAID\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e83 (95%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e51 (94%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e32 (97%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026gt;0.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eMucolytics\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e63 (72%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e36 (67%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e27 (82%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.12\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eOther outcomes\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eHospital stay, days\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e7.0 (7.0, 9.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e7.0 (7.0, 7.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e9.0 (7.0, 13.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.002\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\"\u003e\n \u003cp\u003e\u003cem\u003e\u003csup\u003e1\u0026nbsp;\u003c/sup\u003e\u003c/em\u003eMedian (IQR); n (%).\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u003csup\u003e2\u0026nbsp;\u003c/sup\u003e\u003c/em\u003eWilcoxon rank sum test; Pearson\u0026rsquo;s Chi-squared test; Fisher\u0026rsquo;s exact test.\u003c/p\u003e\n \u003cp\u003eNSAID, non-steroidal anti-inflammatory drugs.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"100%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTable 4. Outcomes of patients subjected to tracheoplasty\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd height=\"43\" style=\"width: 0px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 62px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eComplications\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 37px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOverall\u003c/strong\u003e, N = 87\u003cem\u003e\u003csup\u003e1\u003c/sup\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd height=\"32\" style=\"width: 0px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd height=\"32\" style=\"width: 0px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 62px;\"\u003e\n \u003cp\u003eComplications per patient, n\u003cem\u003e\u003csup\u003e2\u003c/sup\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 37px;\"\u003e\n \u003cp\u003e3.0 (2.0, 4.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 0px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 62px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAnastomosis-related complications\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 37px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 0px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 62px;\"\u003e\n \u003cp\u003eRestenosis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 37px;\"\u003e\n \u003cp\u003e21 (24%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 0px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 62px;\"\u003e\n \u003cp\u003eDehiscence\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 37px;\"\u003e\n \u003cp\u003e7 (8.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 0px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 62px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSystemic complications\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 37px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 0px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 62px;\"\u003e\n \u003cp\u003eGranulation tissue\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 37px;\"\u003e\n \u003cp\u003e16 (18%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 0px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 62px;\"\u003e\n \u003cp\u003eTracheitis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 37px;\"\u003e\n \u003cp\u003e14 (16%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 0px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 62px;\"\u003e\n \u003cp\u003ePermanent tracheostomy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 37px;\"\u003e\n \u003cp\u003e12 (14%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 0px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 62px;\"\u003e\n \u003cp\u003ePneumonia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 37px;\"\u003e\n \u003cp\u003e10 (11%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 0px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 62px;\"\u003e\n \u003cp\u003eDysphonia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 37px;\"\u003e\n \u003cp\u003e8 (9.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 0px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 62px;\"\u003e\n \u003cp\u003eWound infection\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 37px;\"\u003e\n \u003cp\u003e6 (6.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 0px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 62px;\"\u003e\n \u003cp\u003eShock\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 37px;\"\u003e\n \u003cp\u003e5 (5.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 0px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 62px;\"\u003e\n \u003cp\u003eIMV requirement\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 37px;\"\u003e\n \u003cp\u003e5 (5.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 0px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 62px;\"\u003e\n \u003cp\u003eHemoptysis (non-residual)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 37px;\"\u003e\n \u003cp\u003e4 (4.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 0px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 62px;\"\u003e\n \u003cp\u003eHematoma\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 37px;\"\u003e\n \u003cp\u003e4 (4.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 0px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 62px;\"\u003e\n \u003cp\u003eDeath\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 37px;\"\u003e\n \u003cp\u003e2 (2.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 0px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 62px;\"\u003e\n \u003cp\u003eTracheoesophageal fistula\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 37px;\"\u003e\n \u003cp\u003e1 (1.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 0px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 62px;\"\u003e\n \u003cp\u003eDysphagia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 37px;\"\u003e\n \u003cp\u003e1 (1.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 0px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 62px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOther\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 37px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 0px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 62px;\"\u003e\n \u003cp\u003eReintervention\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 37px;\"\u003e\n \u003cp\u003e24 (28%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 0px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u003csup\u003e1\u0026nbsp;\u003c/sup\u003e\u003c/em\u003eMedian (IQR); n (%).\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u003csup\u003e2\u0026nbsp;\u003c/sup\u003e\u003c/em\u003eN = 33.\u003c/p\u003e\n \u003cp\u003eIMV, invasive mechanical ventilation.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd height=\"16\" style=\"width: 0px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"100%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTable 5. Microbiological characteristics of patients subjected to tracheoplasty\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 36px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCharacteristics\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOverall\u003c/strong\u003e, N = 87\u003cem\u003e\u003csup\u003e1\u003c/sup\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 46px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAny complication\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNo\u003c/strong\u003e, N = 54\u003cem\u003e\u003csup\u003e1\u003c/sup\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eYes\u003c/strong\u003e, N = 33\u003cem\u003e\u003csup\u003e1\u003c/sup\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ep-value\u003c/strong\u003e\u003cem\u003e\u003csup\u003e2\u003c/sup\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 36px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eIsolate type\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 36px;\"\u003e\n \u003cp\u003eBacteria\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e31 (36%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e9 (17%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e22 (67%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 36px;\"\u003e\n \u003cp\u003eVirus\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e12 (14%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e9 (17%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e3 (9.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e0.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 36px;\"\u003e\n \u003cp\u003ePolymicrobial (bacteria and virus)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e2 (2.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e1 (1.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e1 (3.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e\u0026gt;0.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 36px;\"\u003e\n \u003cp\u003eFungi\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e2 (2.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e1 (1.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e1 (3.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e\u0026gt;0.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 36px;\"\u003e\n \u003cp\u003eNTBM\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e1 (1.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e1 (1.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e0 (0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e\u0026gt;0.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 36px;\"\u003e\n \u003cp\u003eIsolates per patient, n\u003cem\u003e\u003csup\u003e3\u003c/sup\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e1.0 (0.0, 1.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e0.0 (0.0, 0.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e1.0 (0.0, 1.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 36px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSpecific microbes\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 36px;\"\u003e\n \u003cp\u003e\u003cem\u003eS. aureus\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e20 (23%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e4 (7.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e16 (48%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 36px;\"\u003e\n \u003cp\u003e\u003cem\u003eP. aeruginosa\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e6 (6.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e5 (9.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e1 (3.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e0.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 36px;\"\u003e\n \u003cp\u003e\u003cem\u003eE. coli\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e3 (3.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e0 (0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e3 (9.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e0.051\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 36px;\"\u003e\n \u003cp\u003e\u003cem\u003eM. catarrhalis\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e3 (3.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e2 (3.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e1 (3.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e\u0026gt;0.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 36px;\"\u003e\n \u003cp\u003e\u003cem\u003eK. pneumoniae\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e2 (2.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e1 (1.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e1 (3.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e\u0026gt;0.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 36px;\"\u003e\n \u003cp\u003e\u003cem\u003eE. cloacae\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e2 (2.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e1 (1.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e1 (3.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e\u0026gt;0.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 36px;\"\u003e\n \u003cp\u003e\u003cem\u003eS. marcensis\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e1 (1.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e0 (0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e1 (3.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e0.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 36px;\"\u003e\n \u003cp\u003e\u003cem\u003eA. hyrophila\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e1 (1.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e0 (0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e1 (3.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e0.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 36px;\"\u003e\n \u003cp\u003e\u003cem\u003eH. influenzae\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e0 (0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e0 (0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e0 (0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 36px;\"\u003e\n \u003cp\u003e\u003cem\u003eS. pneumoniae\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e0 (0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e0 (0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e0 (0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 36px;\"\u003e\n \u003cp\u003e\u003cem\u003eS. maltophila\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e0 (0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e0 (0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e0 (0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 36px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOther characteristics\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 36px;\"\u003e\n \u003cp\u003eDrug resistance\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e11 (13%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e3 (5.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e8 (24%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e0.018\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u003csup\u003e1\u0026nbsp;\u003c/sup\u003e\u003c/em\u003eMedian (IQR); n (%).\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u003csup\u003e2\u0026nbsp;\u003c/sup\u003e\u003c/em\u003eWilcoxon rank sum test; Pearson\u0026rsquo;s Chi-squared test; Fisher\u0026rsquo;s exact test.\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u003csup\u003e3\u003c/sup\u003e\u003c/em\u003e Of different species.\u003c/p\u003e\n \u003cp\u003eNTBM, non-tuberculous mycobacteria.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"100%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTable 6. Logistic regression analysis of the factors associated with having any complication in patients subjected to tracheostomy\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 30px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCharacteristic\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOR\u003c/strong\u003e\u003cem\u003e\u003csup\u003e1\u003c/sup\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e95% CI\u003c/strong\u003e\u003cem\u003e\u003csup\u003e1\u003c/sup\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ep-value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eq-value\u003c/strong\u003e\u003cem\u003e\u003csup\u003e2\u003c/sup\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 30px;\"\u003e\n \u003cp\u003e\u003cem\u003eS. aureus\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14px;\"\u003e\n \u003cp\u003e11.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18px;\"\u003e\n \u003cp\u003e3.74, 45.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 30px;\"\u003e\n \u003cp\u003eAny bacterial isolet\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14px;\"\u003e\n \u003cp\u003e10.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18px;\"\u003e\n \u003cp\u003e3.75, 29.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 30px;\"\u003e\n \u003cp\u003eComplex stenosis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14px;\"\u003e\n \u003cp\u003e6.40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18px;\"\u003e\n \u003cp\u003e1.12, 121\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.035\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e0.454\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 30px;\"\u003e\n \u003cp\u003eMulti-segmented stenosis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14px;\"\u003e\n \u003cp\u003e5.78\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18px;\"\u003e\n \u003cp\u003e1.24, 41.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.025\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e0.418\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 30px;\"\u003e\n \u003cp\u003eDrug resistance\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14px;\"\u003e\n \u003cp\u003e5.44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18px;\"\u003e\n \u003cp\u003e1.44, 26.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.012\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e0.280\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 30px;\"\u003e\n \u003cp\u003eIsolets per patient\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14px;\"\u003e\n \u003cp\u003e3.24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18px;\"\u003e\n \u003cp\u003e1.60, 7.23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.029\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 30px;\"\u003e\n \u003cp\u003eCotton classification\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14px;\"\u003e\n \u003cp\u003e2.80\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18px;\"\u003e\n \u003cp\u003e1.10, 7.72\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.031\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e0.452\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 30px;\"\u003e\n \u003cp\u003eBlood loss\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14px;\"\u003e\n \u003cp\u003e1.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18px;\"\u003e\n \u003cp\u003e1.00, 1.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.011\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e0.280\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u003csup\u003e1\u0026nbsp;\u003c/sup\u003e\u003c/em\u003eOR = Odds Ratio, CI = Confidence Interval.\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u003csup\u003e2\u0026nbsp;\u003c/sup\u003e\u003c/em\u003eFalse discovery rate correction for multiple testing.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-pulmonary-medicine","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"pulm","sideBox":"Learn more about [BMC Pulmonary Medicine](http://bmcpulmmed.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/pulm/default.aspx","title":"BMC Pulmonary Medicine","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Airway obstruction, Tracheoplasty, Airway colonization, Postoperative complications, Staphylococcus aureus","lastPublishedDoi":"10.21203/rs.3.rs-8354585/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8354585/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eTracheoplasty offers definitive treatment for high-grade tracheal stenosis but carries a high risk of postoperative complications. While structural and clinical predictors have been widely studied, the influence of airway colonization and antibiotic prophylaxis remains unclear. The objective of this study was to identify clinical, anatomical, and microbiological predictors of postoperative complications in patients undergoing tracheal resection and end-to-end anastomosis.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eWe conducted a retrospective cohort study of 87 adult patients who underwent tracheoplasty at a national referral center. Demographic, anatomical, surgical, and microbiological data were collected. Airway colonization was defined by positive cultures obtained preoperatively. Prophylactic antibiotic use was defined as systemic antibiotics administered within 24 hours of surgery. Multivariable logistic regression was used to identify predictors of overall and specific complications.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eAt least one postoperative complication occurred in 39% of patients, with 26% occurring at the anastomosis site. Predictors of complications included multisegmental or complex stenosis, higher Cotton classification, and greater intraoperative blood loss. Airway colonization with \u003cem\u003eStaphylococcus aureus\u003c/em\u003e was a strong independent predictor of several complications, including pneumonia (OR 21.7, q\u0026thinsp;=\u0026thinsp;0.002), tracheitis, dehiscence, and surgical reintervention. Colonization with drug-resistant or multiple organisms further increased risk. Viral isolates had no measurable impact on outcomes. Despite being administered in 80% of patients, protocolized antibiotic prophylaxis showed no association with reduced complications or infection-related events.\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e \u003cp\u003eMicrobiological colonization, particularly with \u003cem\u003eS. aureus\u003c/em\u003e, is a key predictor of adverse outcomes after tracheoplasty, independent of structural severity or comorbidities. Our results support the need for microbiology-informed perioperative strategies to reduce morbidity.\u003c/p\u003e\u003ch2\u003eTrial registration:\u003c/h2\u003e \u003cp\u003eThis was a retrospective observational cohort study conducted using routinely collected clinical data. As no intervention was prospectively assigned and no randomization or protocol-driven treatment allocation was performed, this study does not qualify as a clinical trial and was therefore not registered.\u003c/p\u003e","manuscriptTitle":"Colonization by Staphylococcus aureus Predicts Postoperative Complications After Tracheoplasty for Airway Stenosis","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-01-09 08:44:23","doi":"10.21203/rs.3.rs-8354585/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"editorInvitedReview","content":"","date":"2026-02-01T01:33:52+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-01-13T02:53:50+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-01-10T17:14:47+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"166067416762747637631975487023163679927","date":"2026-01-10T15:43:55+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"25828277446225564188234386104377149468","date":"2026-01-07T14:55:57+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"92343385542108261273542214221517323807","date":"2026-01-07T08:23:45+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-01-07T07:31:45+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-12-17T12:04:00+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-12-17T02:43:08+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-12-17T02:41:31+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Pulmonary Medicine","date":"2025-12-13T18:46:02+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-pulmonary-medicine","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"pulm","sideBox":"Learn more about [BMC Pulmonary Medicine](http://bmcpulmmed.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/pulm/default.aspx","title":"BMC Pulmonary Medicine","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"3a8583f8-309b-4590-bfed-fe066abaefd5","owner":[],"postedDate":"January 9th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-01-09T08:44:23+00:00","versionOfRecord":[],"versionCreatedAt":"2026-01-09 08:44:23","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8354585","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8354585","identity":"rs-8354585","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}