The ESTS-AIR database-initial results of a multi-institutional database on airway surgery.

OBJECTIVES: Compared to lung resections, airway procedures are relatively rare in thoracic surgery. Despite this, a growing number of dedicated airway centers has formed throughout Europe. These centers are characterized by a close interdisciplinary collaboration and they often act as supra-regional referring centers. To date, most evidence of airway surgery comes from retrospective, single-center analysis as there is a lack of large-scale, multi-institutional databases.

METHODS: In 2018, an initiative was formed, which aimed to create an airway database within the framework of the ESTS database (AIR-ESTS). Five dedicated airway centers were asked to test the database in a pilot phase. A first descriptive analysis of AIR-ESTS was performed.

RESULTS: A total of 415 cases were included in the analysis. For adults, the most common indication for airway surgery was post-tracheostomy stenosis and idiopathic subglottic stenosis; in children, most resections/reconstructions had to be performed for post-intubation stenosis. Malignant indications required significantly longer resections (36.0 (21.4-50.6) mm) when compared to benign indications (26.6 (9.4-43.8) mm). Length of hospital stay was 11.0 (4.1-17.3) days (adults) and 13.4 (7.6-19.6) days (children). Overall, the rates of complications were low with wound infections being reported as the most common morbidity.

CONCLUSIONS: This evaluation of the first cases in the AIR-ESTS database allowed a large-scale analysis of the practice of airway surgery in dedicated European airway centers. It provides proof for the functionality of AIR-ESTS and sets the basis for rolling out the AIR subsection to all centers participating in the ESTS database.