Single center experience of laser tracheobronchoplasty and review of the literature

Excessive central airway collapse can significantly impact quality of life and put patients at risk of respiratory complications. For patients with moderate or mild symptomatic disease, or those that are not candidates for surgical approaches, limited treatment modalities have been described for management of ECAC. However, case reports support the use of endoscopic approaches, specifically, laser assisted tracheobronchoplasty. Here we present a single center experience of laser-assisted TBP (L-TBP) for the management of ECAC. An IRB approved retrospective chart review was performed for patients who underwent L-TBP. A total of 16 L-TBP procedures were performed for 6 patients in our institution over the last 6 years. 4 out of the six patients showed improvement in the amount of airway collapse seen on dynamic CT scan or awake bronchoscopy as compared to baseline imaging or bronchoscopy. 5 out of the 6 patients who underwent L-TBP reported subjective improvement in their baseline symptoms of cough or dyspnea. Our data, while small supports the fact that L-TBP may be an alternative effective means of treating ECAC in select patients with subjective improvements in their symptoms. Further prospective trials are needed to validate this method as a means of treated ECAC.