Three-dimensional tracheo-bronchial reconstruction to plan endoscopic stent insertion for malignant upper airway...

Malignant central airway obstruction (MCAO) is a condition characterized by severe dyspnoea and high mortality. Tracheo-bronchial stents have emerged as an effective treatment to restore airway patency. Our study aimed to evaluate the efficacy of 3D reconstruction of the upper airways to plan tracheo-bronchial stent insertion for MCAO.

This was a retrospective, single-centre observational study. We analysed data of patients undergoing tracheo-bronchial stent insertion for MCAO from January 2012 to January /2024. Patients undergoing tracheo-bronchial stent insertion for MCAO with 3D reconstruction (3D Reconstruction Group) were compared with patients treated prior to the use of 3D reconstruction (Standard Group).

A total of 136 patients were included in our study: 40 patients (29%) in the 3D Reconstruction Group and 96 patients (71%) in the Standard Group. Restore of airway patency was obtained in 96% of patients, without differences between groups (P = 0.48). Median operative time was 40 min in 3D Reconstruction Group vs 48 min in Standard Group, with a percentage reduction of 17% in the 3D Group (P = 0.03). Stent migration was less frequent in 3D Reconstruction Group than in Standard Group, being 5% vs 17% (P = 0.04). There were no significant differences in 30- and 90-day mortality.

Three-dimensional reconstruction of the upper airways was associated with reduced operative time and stent migration rate in patients with MCAO. Reconstructing patients' anatomical features optimizes the procedure without any added cost or delay of the treatment.