Institutional Insights into the Management and Surgical Resection of Tracheobronchial Lesions: Experience with 11 Patients.

Abstract

Pathologic conditions affecting the central airways encompass a wide array of focal alterations. The diagnosis of central airway lesions poses considerable challenges due to their varied presentations, resulting in delayed recognition and management. However, advances in bronchoscopy and multidetector computed tomography (MDCT) aid in early detection. Management depends both on the pathology and the obstructive potential of the process. We present our experience with the comprehensive evaluation and management of 11 cases of focal tracheobronchial lesions surgically treated at our institution, with an emphasis on lung parenchyma preservation. This is a retrospective analysis of prospectively maintained data of 11 patients who were surgically treated for focal tracheobronchial lesions between January 2021 and December 2023 at a tertiary care hospital in India. Their demographic data, clinical presentation, and perioperative details were recorded. All patients underwent MDCT chest, bronchoscopy, and pulmonary function tests as part of the workup for diagnosis and assessment. The study included nine male and two female patients with a mean age of 36.4 years (range 9-64 years). Surgical procedures included main bronchus sleeve resection (3 patients), sleeve lobectomies (3 patients), sleeve bi-lobectomy (1 patient), and tracheal resection with end-to-end anastomosis (4 patients). Postoperatively, one patient died due to acute respiratory distress syndrome (ARDS). Pathological evaluation revealed malignant causes in 9 patients and non-neoplastic causes in 2 patients. The mean hospital stay was 6.5 days, with chest tube removal at 5.6 days. The average follow-up period was 8.2 months, ranging from 6 to 15 months. Based on our series, we ascertain that a complete resection, whenever feasible, offers optimal potential benefits and symptom alleviation for individuals with focal tracheobronchial lesions. Enhanced recognition of these lesions, coupled with a heightened level of suspicion and prompt diagnosis, stands pivotal in ensuring the safe and efficacious management of such cases.