Therapeutic Bronchoscopic Interventions for Non Foreign-Body Removal Indications in Children

Area of Science:

• Pediatric Pulmonology
• Interventional Pulmonology
• Pediatric Airway Management

Background:

• Indications for pediatric airway endoscopy are expanding beyond foreign body removal.
• Therapeutic interventions are increasingly feasible for central airway obstruction (CAO) and other central airway pathologies in children.

Purpose of the Study:

• To describe the indications, procedures, outcomes, and complications of therapeutic bronchoscopic interventions in children for non-foreign body removal indications.

Main Methods:

• Retrospective chart review conducted across four centers.
• Analysis of 143 therapeutic bronchoscopic interventions in 72 children (mean age: 140 months) between January 2015 and November 2023.
• Procedures included airway dilatation, endoluminal tumor debulking, and stent insertion, utilizing rigid or flexible bronchoscopes.

Main Results:

• 67 (93%) of patients had CAO, with common diagnoses including post-tubercular tracheobronchial stenosis (29%), central airway tumors (26%), and post-intubation tracheal stenosis (26%).
• Airway stenosis was the most frequent finding (59.7%), followed by endoluminal growth (29.2%).
• Immediate procedural success was achieved in 92% of patients, with 19.4% experiencing minor complications. Repeat procedures were needed in 46% of children.

Conclusions:

• Multimodality therapeutic bronchoscopic airway interventions are feasible and safe in pediatric patients with CAO and other central airway indications.
• Similar to adult populations, these advanced bronchoscopic techniques offer effective treatment options for complex pediatric airway diseases.