Abstract:

Objective

To analyze the efficacy and safety of bronchoscopic holmium laser in the treatment of central airway obstruction （CAO） while investigating its distinctive role in obstruction caused by various diseases，thus providing valuable insights for clinicians when applying this technique.

Methods

All of 7 patients with central airway obstruction caused by various etiologies selected from Zhuzhou Second Hospital between December 2017 and August 2023. These patients were all treated with bronchoscopic holmium laser therapy，and it was analyzed these cases carefully to evaluate the safety and efficacy of this treatment method in central airway obstruction.

Results

The patients consisted of 2 females and 5 males，Age 57 ～69 years old，with an average age of （65.43±6.32）years. Based on etiology，benign central airway obstruction was observed in 4 patients，while malignant central airway obstruction was present in 3 patients. Obstruction lesions involved the trachea 2 cases as well as the main or intermediate bronchus 5 cases. The primary etiologies encompassed a diverse range including hamartoma 1 case，post-tracheotomy stenosis 1 case，bronchial foreign body 1 case，bronchial calculus 1 case，and central airway obstruction due to lung cancer 3 cases. The patient was treated with holmium laser under bronchoscopy. There was a small amount of bleeding during the treatment，and no complications such as pneumothorax or infection occurred. After treatment，the symptoms such as chest tightness，shortness of breath，cough and expectoration were alleviated or disappeared.

Conclusion

Bronchoscopic holmium laser therapy has several advantages in the treatment of central airway obstruction such as rapid removal of lesions and clear surgical field，in particular，it plays an irreplaceable role in ablating bony foreign bodies and destroying dislocated stent，and it is safe in the treatment process. Notably，this technology is suitable for treating both benign and malignant lesions，holding significant value as a therapy option.

Key words: Central airway obstruction, Holmium laser, Bronchoscope, Clinical application