Interventional pulmonology techniques for treating malignant large airway obstruction: an update

Abstract

This paper reviews the recent literature on the management of malignant large airway obstruction using interventional pulmonology techniques. A number of interventional techniques have been developed during the last 25 years. Recent papers expand on this work, reaffirming the utility of laser bronchoscopy; introducing newer, less expensive technologies with similar outcomes; and attesting to the benefit of airway stenting. Electrocautery is likely to replace laser as the preferred tool for coagulation of intrinsic airway tumors because it is readily available in most hospitals and is much less expensive to set up. Several large series have attested to the excellent results achieved with airway stents placed to relieve extrinsic large airway obstruction. Investigators are using new technologies in an attempt to predict the proper location of stent placement to achieve maximum palliation of symptoms. Published guidelines are available describing the application of interventional techniques. A number of interventional pulmonology techniques are available to treat large airway obstruction from malignant tumor. Clinical studies and personal experience attest to their utility. More evidenced-based studies are needed to help determine the best technique for a particular type of obstruction.