Association of prior endoscopic airway treatment with reintervention after tracheal resection for benign stenosis

OBJECTIVE: Whether prior endoscopic airway treatment identifies patients at increased risk of reintervention after tracheal resection remains uncertain. We evaluated delayed airway reintervention after tracheal resection for benign stenosis according to prior therapeutic endoscopic treatment. METHODS: Adults undergoing first tracheal resection for benign stenosis from January 1, 2016, through August 22, 2025, were identified in a multicenter electronic health record network. Patients with therapeutic endoscopic airway intervention during the preceding 730 days were compared with those without documented recent treatment. Cohorts were propensity score matched 1:1. The primary outcome was airway reintervention during postoperative days 31-365. Prespecified sensitivity analyses restricted the outcome window to days 91-365, limited exposure to prior dilation, and excluded prior airway stenting. A post hoc analysis expanded the study period to 2010-2025. RESULTS: Among 590 eligible patients, 376 had prior endoscopic treatment and 214 had no documented recent treatment. Matching generated 121 pairs. Reintervention occurred in 38/121 (31.4%) versus 30/121 (24.8%) patients (absolute difference, 6.6 percentage points; HR, 1.34; 95% CI, 0.83-2.16; P=0.229). No association was observed during days 91-365 (HR, 1.02; 95% CI, 0.58-1.79; P=0.953) or after excluding prior stenting (HR, 1.30; 95% CI, 0.78-2.17; P=0.316). The expanded cohort included 169 matched pairs and remained neutral (HR, 1.05; 95% CI, 0.71-1.56; P=0.812). CONCLUSIONS: Prior therapeutic endoscopic airway treatment was not significantly associated with delayed reintervention after tracheal resection for benign stenosis. Treatment history alone may be insufficient to identify patients at increased risk of postoperative airway reintervention.