Original Article


Endoscopic management of critical neoplastic central airway obstruction

Alfonso Fiorelli, Roberto Cascone, Davide Di Natale, Annalisa Carlucci, Gaetana Messina, Emanuele De Ruberto, Giovanni Liguori, Vincenzo Pota, Filomena Peluso, Luigi Ferrante, Mario Santini

Abstract

Background: To evaluate morbidity, mortality, and survival of interventional bronchoscopy for management of critical neoplastic central airway obstruction.
Methods: This is a retrospective single-center study included all consecutive patients with neoplastic central airway obstruction undergoing interventional bronchoscopy. Characteristics of obstruction, endoscopic strategy, adjuvant treatments, morbidity, mortality, and survival were recorded and then statistically analysed.
Results: Our study population counted 37 patients (mean age 67±15 years old). The trachea was involved in 6 (16%), the carina in 5 (14%), and the main bronchus in 26 (70%) patients. Restore of airway patency was obtained in 33 (89%) patients. A stent was inserted in 21 (57%) patients. Adjuvant therapy was carried out in 13/37 (35%) patients. The median overall survival was 17 months. The re-opening of airway (P<0.001) and the administration of adjuvant therapy (P=0.001) significantly improved the survival.
Conclusions: Interventional bronchoscopy is a life-saving procedure in non-surgical patients with central airway obstruction. Recanalization of airway and the administration of adjuvant therapy remain the only significant survival prognostic factors.

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