Comparison of continuous and interrupted sutures in tracheal resection and anastomosis: A cohort study with propensity score matching.

Abstract

We introduced several modifications to the anastomosis technique of tracheal resection and anastomosis (TRA), including the use of a continuous technique instead of the traditional interrupted method, omission of traction sutures, application of polydioxanone sutures instead of polyglactin (Vicryl; Ethicon), and a reduction in tracheal release maneuvers. Here, we aimed to comprehensively compare these 2 techniques. In this cohort study, patients who underwent type I TRA (no laryngeal involvement) for tracheal stenosis between April 2018 and October 2024 were divided into 2 groups based on anastomosis technique, including continuous TRA (cTRA) and interrupted TRA (iTRA). Postoperative outcomes such as anastomotic complications (dehiscence, granulation, and recurrence), and surgical site issues were assessed through follow-up and bronchoscopy. Propensity score matching was applied, and comparative analyses were conducted using standard statistical methods. Of 334 patients undergoing type I TRA, 321 were analyzed (62 cTRA, 259 iTRA). After propensity score matching, 48 pairs were compared. Baseline characteristics were similar. Anastomosis time was 20.9 ± 3.1 versus 40.4 ± 5.4 minutes, after propensity score matching (95% CI, 18.2-20.7; P < .001, standardized mean difference, 4.15; 95% CI, 3.18-5.13). The overall rate of anastomotic complications did not differ significantly between groups (odds ratio, 0.72; 95% CI, 0.29-1.80; P = .64). Recurrence rates and the need for reintervention or reoperation were also similar. No statistically significant difference was observed in the granulation tissue formation, dehiscence, recurrence, wound infections, seroma/hematoma, or vocal cord paralysis across matched groups. Continuous polydioxanone sutures for TRA type I, offer similar outcomes as the traditional methods with significantly reduced operative time and improved procedural convenience.