Factor analysis of perioperative complications in anesthetic support of surgeries for cicatricial tracheal stenosis

Reconstructive surgery is an effective method for cicatricial tracheal stenosis requiring special methods of respiratory support under prolonged opening of airway lumen. In this case, complications can follow interaction of various causes, and knowledge of these factors can prevent risks in some cases. Objective. To establish the relationships of prerequisites for perioperative complications in anesthetic support of surgery for cicatricial tracheal stenosis. Material and methods. Correlation and factor analysis was accompanied by calculation of factor loads using principal component analysis of 33 clinical and morphological indicators. The last ones were obtained in prospective non-randomized comparative study of 46 patients aged 18-60 years with cicatricial tracheal stenosis. Results. We identified 9 the most important controlled characteristics of perioperative complications ranked by weight significance: 1) “somatic” with 3 variables (Charlson comorbidity index, 10-year survival and age); 2) “intraoperative airway obstruction” associated with blood aspiration, method of respiratory support and technically difficult intubation; 3) “extent of stenosis”; 4) “violation of surgical comfort”; 5) “stenosis level” (thoracic tracheal stenosis occurred in 67.9% of cases and was prognostically unfavorable compared to cervical stenosis); 6) “cardiovascular”; 7) “hypercapnia” (the most common complication at the stage of tracheal resection was registered in 95.65% of patients and associated with ventilation disorders following specialized respiratory support methods); 8) “structural complications” associated with bleeding from vascular damage, pneumothorax; 9) “pneumomediastinum” associated with cardiac arrhythmia. Conclusion. Factor analysis identified hidden correlations of complications, ranked them according to strength of impact and formed a hypothesis to offset the risk of complications.