R L Ho, S S Kho, C S Chai, S Eng, S K Chan, M C Yong, S T Tie
{"title":"Procedural safety and outcome of rigid bronchoscopy in malignant central airway obstruction.","authors":"R L Ho, S S Kho, C S Chai, S Eng, S K Chan, M C Yong, S T Tie","doi":"","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Malignant central airway obstruction (CAO) affects 20-30% of patients with primary lung cancer and is associated with poor prognosis without treatment. Therapeutic rigid bronchoscopy (RB) is an essential diagnostic and therapeutic tool in this group of patients. We aimed to assess the overall procedural outcomes and safety of RB for symptomatic malignant CAO at our institution.</p><p><strong>Materials and methods: </strong>Retrospective chart review included 57 patients with malignant CAO who underwent RB between March 2016 and June 2022.</p><p><strong>Results: </strong>Our cohort comprised 75.4% males with a median age of 60 years. Isolated right and left main bronchus involvement was observed in 50% and 41.7% of the patients, respectively, with 21.1% experiencing concurrent tracheal involvement. In our cohort, 80% had primary lung cancer, with 35.1% of these cases being squamous cell carcinoma. The re-canalization success rate was 98%, with no intraoperative or immediate postoperative mortality. More than half of the patients (54.4%) required airway stenting to maintain patency after re-canalization. Patients with tracheal involvement, non-intrinsic type of CAO, and right main bronchus involvement had a higher likelihood of requiring airway stenting. There were 24 cases with mild, self-limiting complications and 3 cases with severe procedure-related complications. The 30-day survival rate of our cohort was 91.6%.</p><p><strong>Conclusion: </strong>RB is a safe and effective procedure in patients with malignant CAO. Long term prospective data from multiple centers in our region are anticipated to determine long-term safety and outcomes.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"80 4","pages":"425-431"},"PeriodicalIF":0.0000,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Medical Journal of Malaysia","FirstCategoryId":"1085","ListUrlMain":"","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
Abstract
Introduction: Malignant central airway obstruction (CAO) affects 20-30% of patients with primary lung cancer and is associated with poor prognosis without treatment. Therapeutic rigid bronchoscopy (RB) is an essential diagnostic and therapeutic tool in this group of patients. We aimed to assess the overall procedural outcomes and safety of RB for symptomatic malignant CAO at our institution.
Materials and methods: Retrospective chart review included 57 patients with malignant CAO who underwent RB between March 2016 and June 2022.
Results: Our cohort comprised 75.4% males with a median age of 60 years. Isolated right and left main bronchus involvement was observed in 50% and 41.7% of the patients, respectively, with 21.1% experiencing concurrent tracheal involvement. In our cohort, 80% had primary lung cancer, with 35.1% of these cases being squamous cell carcinoma. The re-canalization success rate was 98%, with no intraoperative or immediate postoperative mortality. More than half of the patients (54.4%) required airway stenting to maintain patency after re-canalization. Patients with tracheal involvement, non-intrinsic type of CAO, and right main bronchus involvement had a higher likelihood of requiring airway stenting. There were 24 cases with mild, self-limiting complications and 3 cases with severe procedure-related complications. The 30-day survival rate of our cohort was 91.6%.
Conclusion: RB is a safe and effective procedure in patients with malignant CAO. Long term prospective data from multiple centers in our region are anticipated to determine long-term safety and outcomes.
期刊介绍：
Published since 1890 this journal originated as the Journal of the Straits Medical Association. With the formation of the Malaysian Medical Association (MMA), the Journal became the official organ, supervised by an editorial board. Some of the early Hon. Editors were Mr. H.M. McGladdery (1960 - 1964), Dr. A.A. Sandosham (1965 - 1977), Prof. Paul C.Y. Chen (1977 - 1987). It is a scientific journal, published quarterly and can be found in medical libraries in many parts of the world. The Journal also enjoys the status of being listed in the Index Medicus, the internationally accepted reference index of medical journals. The editorial columns often reflect the Association''s views and attitudes towards medical problems in the country. The MJM aims to be a peer reviewed scientific journal of the highest quality. We want to ensure that whatever data is published is true and any opinion expressed important to medical science. We believe being Malaysian is our unique niche; our priority will be for scientific knowledge about diseases found in Malaysia and for the practice of medicine in Malaysia. The MJM will archive knowledge about the changing pattern of human diseases and our endeavours to overcome them. It will also document how medicine develops as a profession in the nation. We will communicate and co-operate with other scientific journals in Malaysia. We seek articles that are of educational value to doctors. We will consider all unsolicited articles submitted to the journal and will commission distinguished Malaysians to write relevant review articles. We want to help doctors make better decisions and be good at judging the value of scientific data. We want to help doctors write better, to be articulate and precise.
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