Primary Tracheal Tumors Research Articles

Treatment outcomes of patients with primary tracheal tumors - analysis of a large retrospective series

ObjectivePrimary tracheal tumors are very rare and their management is not definitely established. Due to its rarity, providing patient care in terms of optimal management poses a considerable challenge. The purpose of this study was to investigate treatment outcomes in patients with these rare tumors.MethodsWe carried out a retrospective analysis of 89 patients with primary tracheal tumors treated at the Maria Sklodowska-Curie National Research Institute of Oncology in Warsaw, Poland, over sixteen years. The study assessed patient demographics, tumor characteristics and treatment. Different treatment options were compared in terms of overall survival, disease-free survival, and progression-free survival.ResultsA total of 89 patients were included in the study. In the group presented, 45 patients underwent primary radical treatment and 44 were qualified for palliative treatment. Surgical resection was performed in 13 patients out of radically treated patients. The 5 year OS rates in the group of patients who underwent radical treatment and in the group of patients who underwent palliative treatment were 45.9% and 2.3%, respectively. In the group of patients who underwent radical surgical treatment, the 5 year OS was 76.9% compared to 35.8% in the group of patients who underwent nonsurgical treatment.ConclusionA multidisciplinary team should decide treatment options, including in-depth consideration of surgical treatment options.

Multislice helical computed tomography imaging diagnosis and surgical treatment of primary tracheal tumor in cardiothoracic surgery.

it aimed to explore the value of multislice helical computed tomography (MSCT) in the diagnosis and surgical treatment of primary tracheal tumors. 64 patients with the primary tracheal tumor who were diagnosed in Wuxi Second People's Hospital from March 2020 to March 2021 were selected as the research objects. MSCT imaging was performed on all patients, and suitable surgical methods. The pathological results were compared with original CT, CT virtual endoscopy (CTVE), and Comparisons were made using CT three-dimensional reconstruction images to evaluate the accuracy of MSCT diagnosis. Parameters such as postoperative complications and survival rates were observed to assess surgical effectiveness and safety. Compared with original CT images (70%, 72%, 70%), the diagnostic accuracy of VR images (80%, 80%, 80%), MPVR images (85%, 90%, 92%), and CTVE images (100%, 100%, 100%) was remarkably improved (P<0.05). The three-year survival rate of patients with smooth muscle tumors, malignant tumors, salivary gland adenoma, papillary tumors, and inflammatory polyp was markedly lower than that of the one-year survival rate, with a significant difference (P<0.05). The incidence of postoperative complications was 14.1%, with three cases resulting in complication-related deaths. the diagnostic accuracy of MSCT imaging of primary tracheal tumor was high. The diagnostic accuracy of CTVE was higher than that of VR and MPVR. Besides, surgical treatment of primary tracheal tumor had a substantial effect, with no serious postoperative complications.

Tracheal Tumours

Malignant primary tracheal tumours are rare. The most common histological subtypes are squamous cell carcinoma and adenoid cystic carcinoma. These two entities have different prognoses and growth patterns. Tracheobronchoscopy and thoracic sectional imaging are standard diagnostic tools for tumour staging and local evaluation. Complete surgical resection of the affected tracheal segment is the treatment of choice for limited disease without distant metastases. Incomplete gross tumour resection with additional irradiation is an acceptable therapeutic option for adenoid cystic carcinoma. Interventional endoscopy with tumour debulking or tracheal stenting and/or definitive mediastinal radiotherapy are treatment alternatives in either a locally advanced or palliative setting.

A Deceptive Tracheal Mass Mimicking Asthma

Primary tracheal tumours represent a rare malignancy characterized by a generally slow growth pattern. Notably, most cases are not of primary tracheal origin; instead, they arise from the local invasion of cancers originating in the lung, thyroid, or esophagus. Adenoid cystic carcinomas (ACCs) represent the second most prevalent primary tracheal tumours, making up around 10%–15% of cases. They generally have a more favourable prognosis than squamous cell carcinoma, the most frequently encountered type. Herein, we present the case of a 35-year-old female patient misdiagnosed and treated as asthma. The diagnosis was confirmed by cryo biopsy and histopathological examination. Surgical excision remains the treatment of choice. An active follow-up surveillance is needed to look for recurrence.

Molecular Biology and Therapeutic Targets of Primitive Tracheal Tumors: Focus on Tumors Derived by Salivary Glands and Squamous Cell Carcinoma.

Primary tracheal tumors are rare, constituting approximately 0.1-0.4% of malignant diseases. Squamous cell carcinoma (SCC) and adenoid cystic carcinoma (ACC) account for about two-thirds of these tumors. Despite most primary tracheal cancers being eligible for surgery and/or radiotherapy, unresectable, recurrent and metastatic tumors may require systemic treatments. Unfortunately, the poor response to available chemotherapy as well as the lack of other real therapeutic alternatives affects the quality of life and outcome of patients suffering from more advanced disease. In this condition, target therapy against driver mutations could constitute an alternative to chemotherapy, and may help in disease control. The past two decades have seen extraordinary progress in developing novel target treatment options, shifting the treatment paradigm for several cancers such as lung cancer. The improvement of knowledge regarding the genetic and biological alterations, of major primary tracheal tumors, has opened up new treatment perspectives, suggesting the possible role of biological targeted therapies for the treatment of these rare tumors. The purpose of this review is to outline the state of knowledge regarding the molecular biology, and the preliminary data on target treatments of the main primary tracheal tumors, focusing on salivary-gland-derived cancers and squamous cell carcinoma.

Survival benefit of radiotherapy and nomogram for patients with primary tracheal malignant tumors: a propensity score-matched SEER database analysis

PurposeThe purpose of this study was to conduct a matched-pair analysis to assess the impact of radiotherapy (RT) on patients with malignant tracheal tumors using the surveillance, epidemiology, and end results database. Additionally, a predictive nomogram was developed for patients with malignant tracheal tumors.MethodsPropensity score matching (PSM) was used to minimize bias between the RT and no-RT groups. We utilized both univariate and multivariate Cox proportional hazards regression analyses to identify independent prognostic factors for patients and subgroups. We developed a novel nomogram and evaluated its results using the C-index.ResultsA total of 648 patients between 1975 and 2019 were included, and 160 patients in RT were 1:1 propensity score-matched with no-RT. The independent prognostic factors for patients with tracheal malignant tumors were surgery, marital status, disease extension, pathology, and age. The independent risk factors for patients without surgery included RT and disease extension. The C-index confirmed that the nomogram accurately predicted the prognosis of patients with tracheal malignant tumors.ConclusionsOur findings suggest that RT may provide a survival benefit for tracheal cancer patients who did not undergo surgery. The nomogram can be a useful tool for predicting prognosis in patients with tracheal malignant tumors.

Integrated endoscopic treatment of primitive unresectable tracheal tumor: the INTACT retrospective cohort study.

Primitive tracheal tumors represent a rare entity whose management, when unresectable, remains challenging. Primary aim of this study was to explore the survival and the factors influencing prognosis of patients with unresectable primitive tracheal tumor undergoing multimodal treatment integrating interventional bronchoscopy and radiotherapy. This retrospective cohort study was conducted at the University Hospital of Modena (Italy) over a 12-year period (January 2010 to January 2022) analyzing patients with unresectable primary tracheal tumor receiving interventional bronchoscopy treatment followed by radiotherapy. Survival analysis was conducted for the whole population and according to histology, development of metastasis, stent placement and the onset of disease relapse. The raw and independent association between potential risk factor and 5-year mortality and the reported complications were investigated. A total of 12 patients were included. Five-year survival rate was 42% with a median survival time of 26.7 (interquartile range, 4.1-82) months. Survivors showed a higher prevalence of cystic-adenoid histology (80% vs. 14%), while patients who were dead at 5 years were those with a more advanced T (prevalence of T2: 71% vs. 0%) and a lower response to first line treatment (57% vs. 0%). Treatment complications accounted for stent dislocation (33%) and the onset of granuloma (18%), while no major side effects were reported. The presence of cystic-adenoid histology resulted in significantly improved 5-year survival rate (80% vs. 14%). The onset of distal metastasis, the occurrence of disease relapse and the placement of tracheal stent did not result significantly associated with lower survival. Among analysed variables, only the presence of cystic-adenoid histology resulted independently associated with survival (odds ratio =0.1, P=0.04). Multimodal treatment including interventional bronchoscopy and associated radiotherapy for unresectable primary tracheal tumors seems not burdened by significant complications and may provide benefits in terms of survival for those patients with cystic-adenoid histology.

Primary Tracheal Squamous Cells Carcinoma in a Dog

Primary tracheal neoplasms are uncommon and poorly documented in veterinary medicine, being most frequently reported in domestic cats. Squamous cell carcinoma (SCC) is a malignant neoplasm that originates from the stratified squamous epithelium, considered one of the most common skin neoplasms in dogs and cats. This paper aims to report the anatomopathological and immunohistochemical findings of a clinical case of primary SCC in the trachea of a female Schnauzer canine, attended at the Veterinary Hospital Luiz Quintiliano de Oliveira of the Faculty of Veterinary Medicine of Araçatuba (FMVA – UNESP), complaining of choking, coughing and dyspnea for 1 month. The tracheal portion affected by the neoplasm was sent to the Veterinary Pathology department of the FMVA after surgical excision. Fragments of the neoplasm were collected and fixed in 10% formaldehyde for further histopathological and immunohistochemical analysis. Microscopically, the neoplasm was well differentiated, being characterized by the presence of keratin pearls, low degree of pleomorphism and rare mitotic figures. In the immunohistochemical analysis, there was immunoexpression of anti-cytokeratin antibodies AE1AE3, 34BE12, CK14 and CK5/6, confirming the diagnosis of squamous cell carcinoma. In about 30% of the cells there was immunostaining for Ki67 antibodies, justifying the low mitotic index of tumor cells and the few images of mitosis seen. Due to the rare occurrence of primary tracheal SCC in dogs, the use of diversified diagnostic techniques is important in order to better understand the biological behavior of this neoplasm in unusual anatomical locations.

A TRACHEAL FIBROEPITHELIAL POLYP

A TRACHEAL FIBROEPITHELIAL POLYP

Adenoid cystic carcinoma of trachea presenting as a medical emergency- A case report

Adenoid cystic carcinoma is a chief histologic type of malignancy of minor salivary glands. Primary malignant Tracheal neoplasms are rare &amp;#60;0.1%, with Adenoid Cystic Carcinoma being very rare. It arises from mucous secreting cells of salivary glands and upper respiratory tract. After Squamous Cell Carcinoma it is second most common Primary tracheal malignancy. Diagnosis can be done by Computed Tomography or Magnetic Resonance Imaging. But histopathology remains gold standard of diagnosis.

A novel classification of tracheal defects and the reconstruction strategies: A retrospective study based on 106 cases.

The study aims to present a novel classification of tracheal defects and the corresponding reconstruction strategies. The retrospective study was designed to analyze patients with diagnosed primary or secondary tracheal tumors from 1991 to 2020. Surgical techniques, complications and prognosis were reviewed. Airway status and patient outcomes were the principal follow-up measures. Tracheal defects were classified into two plane sizes (vertical (V) and horizontal (H) planes). Vertical defects were further categorized into three groups based on their tracheal ring numbers (V1, ≤ 5 rings; V2, 6-10 rings; and V3, > 10 rings). Tracheal defects with horizontal plane size H1 and H2 represent defects less and more than one-half the circumference of trachea. Thus, suitable reconstruction strategies were planned primarily based on "V" and "H" classifications. The reconstruction strategies performed were sleeve resection followed by an end-to-end anastomosis, window resection with sternocleidomastoid myoperiosteal flap reconstruction, defects conversion with rotation anastomosis, and modified tracheostomy with secondary flap reconstruction. A total of 106 patients diagnosed with tracheal defects were enrolled in the study, of whom 59 patients underwent sleeve resection followed by end-to-end anastomosis; 40 patients received window resection alongside sternocleidomastoid (SCM) myoperiosteal flap reconstruction; five patients received converting defects with rotation anastomosis and two patients underwent modified tracheostomy with secondary stage flap reconstruction. Lumen stenosis occurred in three V2H1 defect cases and were treated by a second reconstruction surgery. Iatrogenic unilateral recurrent laryngeal nerve paralysis occurred in two patients with the V3H2 defect type, who were treated by temporary tracheotomy and partial vocal cord resection and extubated successfully during follow-up. All 106 patients achieved airway patency with adequate laryngeal function at the end of follow-up. No anastomotic dehiscence or bleeding occurred in any patient postoperatively. Though a significant number of multicenter studies concerning the reconstruction and classification of tracheal defects are needed, the study herein provides a novel classification of tracheal defects, which is primarily developed on the defect size. Therefore, the study might serve as a potential source for identifying suitable reconstruction strategies for practitioners.

Case Report: ECMO-Assisted Uniportal Thoracoscopic Tracheal Tumor Resection and Tracheoplasty: A New Breakthrough Method

Primary tracheal tumors are seldom seen, and most of them are malignant. At present, the main treatment is surgical resection. It is rare to accomplish tracheal tumor resection and tracheoplasty via uniportalal thoracoscopy. In order both to maintain the patient's oxygen supply during surgery and to reduce the size of the surgical incision, we have innovatively integrated the ECMO-assisted and uniportal thoracoscopic techniques for the first time, perfectly achieving tracheal tumor resection and tracheoplasty. The intraoperative manipulation was only 180 min in duration. The patient returned to the intensive care unit and recovered smoothly after the surgery. The patient was discharged from the hospital 17 days after the operation. ECMO-assisted uniportal thoracoscopic tracheal resection and tracheoplasty provides a new idea and method for colleagues.

Do We Need TNM for Tracheal Cancers? Analysis of a Large Retrospective Series of Tracheal Tumors.

Simple SummaryThe TNM (tumor, node, metastases) staging system established by the Union for International Cancer Control/American Joint Committee on Cancer is commonly used to select a treatment method for patients with cancers, guide adjuvant therapy after surgery, and predict the prognosis. It is an essential tool for working with cancer patients in everyday medical practice. Currently, the eighth edition of the TNM staging system is used. Primary tracheal tumors are uncommon neoplasms. Probably due to their rarity, neither an AJCC staging system nor other, widely accepted staging system exists for primary tracheal cancers. Only a few studies stated their proposed guidelines for the staging of tracheal neoplasms. The absence of a universally adopted staging system makes it difficult for clinicians to assess tracheal cancers properly. This makes it challenging to conduct analyses and compare the results of published works. A standard classification system would help assess and qualify patients for treatment and, perhaps, establish uniform indications for adjuvant treatment. All this could contribute to an increase in the proportion of patients qualified for radical surgery, which is the preferred treatment method.Due to the low incidence of primary tracheal neoplasms, there is no uniform system for staging of this disease. Our retrospective analysis based on registry data included 89 patients diagnosed with primary tracheal cancer at the National Research Institute of Oncology in Warsaw, Poland, between January 2000 and December 2016. We analyzed demographic, clinical, pathological, therapeutic, and survival data. The staging—for the purpose of our analysis—was performed retrospectively on the basis of imaging results. Tumor (T) category was defined as a disease confined to the trachea or lesion derived from the trachea and spreading to adjacent structures and organs. Node (N) and metastases (M) categories were divided into absence/presence of metastasis in regional lymph nodes and the absence/presence of distant metastasis. Survival analysis was performed depending on the clinical presentation of these features. There was a significant difference in overall survival depending on the T, N, M categories in the entire group. In the group of patients undergoing radical treatment, the T and N categories had a statistically significant impact on overall survival. In the group of patients treated with palliative aim, only the T category had an impact on overall survival. Multivariate analysis showed statistical significance for the T category in patients undergoing radical and those receiving palliative treatment. The assessment of the anatomical extent of lesions may help decide about treatment options and prognosis.

CASES OF PRIMARY SQUAMOUS CELL CARCINOMA OF TRACHEA IN NON-SMOKERS: OUR EXPERIENCE

Primary tracheal tumours are extremely rare and overwhelmingly malignant.Squamous cell carcinoma is most common in smokers,whereas adenocarcinoma is most commonly found in non-smokers. Patients most commonly presents with hemoptysis, respiratory distress, cough and stridor. The symptoms appear in late phase and often are mistaken for chronic obstructive pulmonary disease.This leads to delay in management.Surgery,followed by adjuvant radiotherapy and chemotherapy,is the treatment of choice.

Prognostic significance of sex in patients with primary tracheal tumors – a retrospective, single-center study

Introduction. We aimed to assess the prognostic significance of the sex of patients with primary tracheal tumors based on our own results as well as the literature review. Material and methods. We carried out a retrospective analysis of 89 patients with primary tracheal tumors treated at the Maria Sklodowska-Curie National Research Institute of Oncology in Warsaw, Poland, between January 2000 and December 2016. Men and women were compared in terms of overall survival, disease-free survival, and progression-free survival. Results. In the entire study group, the median overall survival was 61.30 months in women and 8.55 months in men (p &lt; 0.0001). 5-year overall survival rates were 2.1% in men versus 50.6% in women (p &lt; 0.0001). Among those receiving radical treatment, women had improved survival rates compared with men. Sex was an independent prognostic factor in both the total study population and among those undergoing radical treatment. Conclusions. According to our results, women with primary tracheal tumors have significantly better survival than men. Because female sex is an independent prognostic factor in patients with primary tracheal tumors, the ratio of women to men should be taken into consideration in reports comparing the outcomes of different treatments.

Surgery of primary tracheal tumors

To determine the main forms of primary tracheal cancer (PTC), to specify the indications for various surgeries in these patients depending on extent and localization of lesion. There were 263 PTC patients. Benign tumors were diagnosed in 68 (25.9%) patients, malignancies - in 195 (74.1%) cases. Tracheal cancer includes 3 basic morphological variants - adenocystic cancer (49.7%), carcinoid (18.7%) and squamous cell carcinoma (19.0%). Other forms of malignancies were much less common. We applied endoscopic intraluminal and open surgeries. In malignant PTC, open surgeries were performed in 165 (84.6%) out of 195 patients. Baseline palliative endoscopic treatment was performed in 30 patients. They underwent airway recanalization (with subsequent tracheal stenting in 19 patients). Endoscopic resection was preferred for benign tumors. Twenty (12.1%) patients died after open surgery, and 1 (3.3%) patient died after endoscopic procedure. Most lethal outcomes occurred in early years of development of tracheal surgery. The causes of mortality were tracheal anastomotic failure in 12 patients, pneumonia in 6 patients, and arterial bleeding in 2 patients. Severe postoperative period was observed in all 3 patients after tracheal replacement with a silicone prosthesis. Long-term treatment outcomes depended on morphological structure of PTC. Favorable results were observed in patients with neuroendocrine tumor (carcinoid), worse outcomes in adenocystic cancer and unfavorable results in squamous cell carcinoma (p<0.0013). Five-year survival rates were 75%, 65.6%, and 13.3%; 10-year survival rates were 75%, 56.2%, and 13.3%, respectively. These outcomes after combined treatment of primary tracheal cancer were significantly better compared to lung cancer (p<0.05 when compared to global data). Treatment of primary tracheal cancer should be based on classical principles of modern oncology (combined therapy, tumor resection with lymphadenectomy). Open and endoscopic interventions are justified. PTC is characterized by more favorable outcomes compared to lung cancer. It is difficult to analyze long-term results in tracheal cancer depending on various features of tumor process due to small number of observations. Accurate conclusions require multiple-center studies, preferably with international participation, which can convincingly prove certain concept.

FEATURES OF ANESTHESIA DURING SURGERY FOR TRACHEAL CANCER

Tracheal neoplasms are rare, accounting for 0.10.2% of all malignant neoplasms [I.I. Davydovskyi, 1940]. Data from the database of the National Cancer Institute for Surveillance, Epidemiology and End Results indicate that primary tracheal carcinomas occur with an incidence of 0.7% of new cases per million people [Houston, 1963]. Patients with tracheal tumors can have severe airway obstruction. In addition to primary tracheal neoplasms, secondary tracheal affection may occur due to lesion of surrounding tissues such as thyroid, larynx, and lungs - 15.3%.

Biogeography of the Respiratory Tract Microbiome in Patients With Malignant Tracheal Tumors.

BackgroundThis study aimed to characterize the bacterial microbiota in the oral cavity (OC), throat, trachea, and distal alveoli of patients with primary malignant tracheal tumors (PMTT), including squamous cell carcinoma (SCC) and salivary gland carcinoma patients (SGC), for comparison with a matched non-malignant tracheal tumor (NMTT) group.MethodsPatients with pathological diagnosis of PMTT and NMTT were included in this study. Saliva, throat swab (TS), trachea protected specimen brush (PSB), and bronchoalveolar lavage fluid (BALF) samples were collected for 16S rRNA gene sequencing. The composition, diversity, and distribution of the microbiota were compared among biogeographic sampling sites and patient groups. The relationship between the genera-level taxon abundance and tracheal tumor types was also investigated to screen for candidate biomarkers.FindingsThe most represented phyla in the four sites were Bacteroidetes, Firmicutes, Proteobacteria, and Fusobacteria. In SCC patients, the relative abundance of Bacteroidetes and Firmicutes gradually decreased with increasing depth into the respiratory tract, while the relative abundance of Proteobacteria gradually increased. Bacterial communities at the four biogeographic sites formed two distinct clusters, with OC and TS samples comprising one cluster and PSB and BALF samples comprising the other group. Principal coordinate analysis showed that trachea microbiota in SCC patients were distinct from that of SGC or NMTT patients. In the trachea, AUCs generated by Prevotella and Alloprevotella showed that the abundance of these genera could distinguish SCC patients from both NMTT and SGC patients.InterpretationThe structure of respiratory tract microbiota in PMTT patients is related to tumor type. Certain bacteria could potentially serve as markers of SCC, although verification with large-sample studies is necessary.

The first case of BRG (SMARCA4)/INI Deficient Tracheal Carcinoma: A Case Report and Review of the Literature

Abstract Introduction/Objective Primary tumors of the trachea are rare, they account for less than 0.1% of tumors in humans. In adults, 90% of primary tracheal tumors are malignant, with squamous cell carcinoma and adenoid cystic carcinoma accounting for two-thirds, with other forms occurring less frequently. The BRG (SMARCA4)/INI deficient tumor is a relatively new defined entity which is recently introduced in the WHO Classification of Tumors, 5th edition, 2021. The gene SMARCA4 is located at 19p13. Loss of SMARCA4 has been reported in several aggressive tumors with high- grade undifferentiated rhabdoid morphology but has not been reported in the trachea. Hence, we report the first case of BRG (SMARCA4)/ INI deficient tracheal carcinoma. Methods/Case Report We present a 60-year-old male with a history of tobacco abuse, shortness of breath, and a tracheal mass on chest imaging. Bronchoscopy was performed and showed a fleshy friable lesion at the anterior trachea with evidence of blood dripping into the distal airways. Results (if a Case Study enter NA) Microscopic examination showed a high grade, poorly differentiated carcinoma with tumor necrosis, high mitotic counts, and marked nuclear pleomorphism. Immunohistochemical stains were performed. The tumor cells were strongly and diffusely positive for CK-7 and weakly positive for synaptophysin, negative for pan-cytokeratin, TTF-1, CK-20, p40, CK5/6, and chromogranin. Then BRG (SMARCA4) and INI 1 (BAR47) were performed and showed negative staining on BRG expression, while INI 1 is intact (nuclear expression). These features are consistent with BRG (SMARCA4)/ INI deficient carcinoma. Conclusion BRG (SMARCA4)/ INI deficient carcinoma is a new entity in the trachea, which is very aggressive with a poor prognosis. Targeted therapy or clinical trials may be available as additional cases are diagnosed in the future.

Intraoperative airway management for patients with tracheal tumors: A case series of 37 patients.

BackgroundTracheal tumors are rare. The aim of this case series was to investigate airway selection during radical surgery for patients with tracheal tumors.MethodsHere, we performed a retrospective case review of patients with tracheal tumors who underwent tracheal surgery in our center. A total of 37 cases, including 26 patients with primary tracheal tumors and 11 cases with advanced thyroid cancer, were enrolled into the study. Baseline characteristics and differential prognosis of included patients were estimated. We summarize the strategies for intraoperative airway selection and analyze the risk factors associated with delayed extubation.ResultsThere is a trend for primary tracheal tumors to appear toward the upper (9 of 26) and middle third (9 of 26) of the trachea, followed by the lower third airway (8 of 26). Advanced thyroid cancers occur most frequently in the upper trachea (7 of 11) and then the middle trachea (4 of 11). All primary and secondary patients underwent R0 resection. Minor histological subtypes were found to correlate with a poor prognosis. Extracorporeal support and tracheotomy intubation were applied in high‐risk cases, and a total of 32 patients achieved intrathoracic intubation during the surgical process. Intensive care unit (ICU) delay (>1 day) was observed among 25 patients, which were not enriched in cases who underwent cross‐field endotracheal intubation. Additionally, temporal suboptimal oxygenation (SpO2 < 95%) was an independent risk factor of ICU delay.ConclusionsAirway selection plays an important role in successful tracheal surgery, and an appropriate ventilation routine depends on the patient and a surgical process which is safe and effective.