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Malignant Central Airway Obstruction (MCAO) encompasses significant and symptomatic narrowing of the central airways that can occur due to primary lung cancer or metastatic disease. Therapeutic bronchoscopy is associated with high technical success and symptomatic relief and includes a wide range of airway interventions including airway stents. Published literature suggests that stenting practices vary significantly across the world primarily due to lack of guidance. This document aims to address this knowledge gap by addressing relevant questions related to airway stenting in MCAO. An international group of 17 experts from 17 institutions across 11 countries with experience in using airway stenting for MCAO was convened as part of this guideline statement through the World Association for Bronchology and Interventional Pulmonology (WABIP). We performed a literature and internet search for reports addressing six clinically relevant questions. This guideline statement, consisting of recommendations addressing these six PICO questions, was formulated by a systematic and rigorous process involving the evaluation of published evidence, augmented with expert experience when necessary. Panel members participated in the development of the final recommendations using the modified Delphi technique. Details
Rigid bronchoscopy is a specialised endoscopic modality utilising a rigid scope instrument to afford direct visualisation and intervention within the central airways. In contradistinction to flexible bronchoscopy, the augmented working channel of the rigid instrument permits the introduction of larger-calibre instrumentation, thereby facilitating complex therapeutic procedures. These procedures encompass, inter alia, foreign body retrieval, endoluminal tumour debulking, airway stent deployment, and the management of life-threatening haemoptysis. While the procedure mandates general anaesthesia and a high level of operator expertise, rigid bronchoscopy provides superior airway control and the capacity to address complex airway pathologies that may be refractory to flexible bronchoscopy. Details
sop
Malignant Central Airway Obstruction (MCAO) encompasses significant and symptomatic narrowing of the central airways that can occur due to primary lung cancer or metastatic disease. Therapeutic bronchoscopy is associated with high technical success and symptomatic relief and includes a wide range of airway interventions including airway stents. Published literature suggests that stenting practices vary significantly across the world primarily due to lack of guidance. This document aims to address this knowledge gap by addressing relevant questions related to airway stenting in MCAO. An international group of 17 experts from 17 institutions across 11 countries with experience in using airway stenting for MCAO was convened as part of this guideline statement through the World Association for Bronchology and Interventional Pulmonology (WABIP). We performed a literature and internet search for reports addressing six clinically relevant questions. This guideline statement, consisting of recommendations addressing these six PICO questions, was formulated by a systematic and rigorous process involving the evaluation of published evidence, augmented with expert experience when necessary. Panel members participated in the development of the final recommendations using the modified Delphi technique. Details
Rigid bronchoscopy is a specialised endoscopic modality utilising a rigid scope instrument to afford direct visualisation and intervention within the central airways. In contradistinction to flexible bronchoscopy, the augmented working channel of the rigid instrument permits the introduction of larger-calibre instrumentation, thereby facilitating complex therapeutic procedures. These procedures encompass, inter alia, foreign body retrieval, endoluminal tumour debulking, airway stent deployment, and the management of life-threatening haemoptysis. While the procedure mandates general anaesthesia and a high level of operator expertise, rigid bronchoscopy provides superior airway control and the capacity to address complex airway pathologies that may be refractory to flexible bronchoscopy. Details
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