Rigid Bronchoscopy and Mechanical Debulking in the Management of Central Airway Tumors

Abstract

Treatment options for central airway tumors include surgery, radiotherapy, and in those with inoperable or emergent airway obstruction, therapeutic bronchoscopy. Herein, we report our experience with the exclusive use of rigid bronchoscope in the management of central airway tumors. Retrospective review of charts of patients who underwent rigid bronchoscopy and mechanical coring for the management of central airway (trachea and mainstem bronchi) tumors over a period of 2 years. "Successful" outcome was defined as procedure leading to reduction of luminal obstruction to <50% and improvement of respiratory distress. "Unsuccessful" outcome was defined in cases where the luminal obstruction could not be reduced by ≥50% or there was lack of improvement in the clinical status of the patient. During the study period, 30 patients with symptomatic central airway tumors were encountered. Of these, 23 patients underwent 31 rigid bronchoscopic procedures. Respiratory failure was present in 15 (65.2%) patients. Adenoid cystic carcinoma was the most common primary tracheal tumor, whereas squamous cell carcinoma was the most common secondary tracheobronchial tumor. The procedure was successful in 19 (82.6%) patients. Complications were encountered in 10 of the 31 (32.3%) rigid bronchoscopies. There was no procedural mortality. Rigid bronchoscopy and mechanical debulking as a sole therapy is an effective and safe procedure for airway obstruction resulting from tracheobronchial tumors.