Rigid bronchoscopic interventions for central airway obstruction - An observational study

Area of Science:

• Interventional Pulmonology
• Thoracic Oncology
• Bronchoscopy Techniques

Background:

• Central airway obstruction (CAO) significantly impacts morbidity and mortality in thoracic malignancy patients.
• Rigid bronchoscopy (RB) plays a crucial role in managing CAO.
• This study prospectively evaluates RB's role in multimodality CAO management.

Purpose of the Study:

• To describe the application and outcomes of rigid bronchoscopy in managing central airway obstruction.
• To evaluate the safety and efficacy of RB as part of a multimodality treatment strategy for CAO.

Main Methods:

• Prospective study detailing rigid bronchoscopic techniques for CAO from July 2016 to July 2019.
• Included 152 procedures (124 therapeutic/palliative, 28 diagnostic) in 111 adults and 10 pediatric patients.
• Interventions included mechanical debulking and airway dilatation.

Main Results:

• RB significantly improved dyspnea (MRC scale) and reduced pain (VAS) post-procedure (P < 0.0001).
• Palliation of airway obstruction was achieved in 48.8% and diagnosis in 23.2% of cases.
• Moderate bleeding occurred in 13.3%, primarily during diagnostic RB; 31 patients died from progressive disease.

Conclusions:

• An individualized, interventional approach using RB is safe and effective for CAO palliation.
• RB combined with multimodality treatment successfully achieves palliation goals in most patients.
• RB is a valuable tool in the comprehensive management of central airway obstruction.