Tracheobronchoplasty for Excessive Dynamic Airway Collapse and Tracheobronchomalacia: A Comparative Analysis of Distinct Airway Disorders.

Background: Excessive dynamic airway collapse (EDAC) and tracheobronchomalacia (TBM) are distinct etiologies of excessive central airway collapse; EDAC is characterized by excessive anterior displacement of the posterior membrane, while TBM is due to weakness of the cartilaginous rings. We compare outcomes after tracheobronchoplasty across these two pathologies.

Methods: This was a single-center retrospective study including patients who underwent tracheobronchoplasty between 2018-2023.

The Usefulness of Mediastinal Cryobiopsy in the Diagnosis of Mediastinal Lymphadenopathy in HIV Patients.

Introduction: Mediastinal diseases in HIV patients show complex diagnostic challenges due to opportunistic infections and rare neoplasms. While Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a key technique, its effectiveness is limited as it only provides cytological samples. Endobronchial ultrasound-guided mediastinal cryobiopsy (CryoEBUS) emerges as a promising alternative, yielding larger and higher-quality samples.

Expiratory Central Airway Collapse: A Comprehensive Narrative Review.

Expiratory central airway collapse (ECAC) encompasses 2 subtypes: excessive dynamic airway collapse and tracheobronchomalacia. ECAC manifests as symptoms of dyspnea, chronic cough, difficulty in clearing secretions, and recurrent respiratory infections. Diagnosis involves dynamic flexible bronchoscopy and computed tomography scans.

Procedure-free survival after therapeutic bronchoscopy in patients with central airway obstruction.

Background: Central airway obstruction (CAO) poses a significant risk of respiratory failure, often necessitating urgent intervention. Therapeutic bronchoscopy is a well-established method for palliation or definitive management of CAO. Although similar therapeutic maneuvers are employed for benign and malignant CAO, the long-term effectiveness and influencing factors are not fully described.

An international survey on the practice patterns of intrapleural enzymatic therapy for complicated parapneumonic effusions and empyema.

Background: Pleural space infection is a common clinical problem in thoracic medicine and is associated with significant morbidity and mortality. Prior studies have described multiple treatment strategies in the management of complicated parapneumonic effusions (CPPEs) and empyema. As a result, significant variation likely exists in clinical practice patterns amongst healthcare providers around the world.

Patterns of HER2 expression and genomic correlates in lung cancer, with a focus on preanalytical variables impacting immunohistochemical staining results.

Aims: Fam-trastuzumab deruxtecan-nxki (T-DXd) was recently approved for advanced stage or metastatic solid tumours with human epidermal growth factor receptor 2 (HER2) immunohistochemical (IHC) 3+ staining. Data on HER2 IHC testing and knowledge of genomic correlates in lung cancer are scarce. This study analyses genomic characteristics of HER2-expressing tumours and addresses issues with preanalytical variables for lung cancer specimens.

Tunneled Pleural Catheters: An Effective Nonsurgical Alternative for Nonexpandable Lung in Chronic Pleural Infection.

Background: Open window thoracostomy (OTW) is the standard of care for debilitated patients with chronic pleural infection and nonexpandable lungs (NEL) who are not candidates for major surgical intervention. Tunneled pleural catheters (TPC) offer tremendous treatment potential in this setting based on their efficacy in malignant pleural effusion and NEL. We aim to assess the efficacy, safety, and health care utilization of TPC in this setting.

The Impact of Balloon Use during Endobronchial Ultrasound: A Randomized Pilot Study.

Introduction: During endobronchial ultrasound transbronchial needle aspiration (EBUS-TBNA), a saline-filled balloon placed over the tip of the bronchoscope is used to improve coupling of the ultrasound transducer to the airway wall. However, it is unknown whether it objectively improves image quality or affects procedural outcomes. Our aim was to establish whether the use of a balloon during EBUS impacts image quality, diagnostic yield, procedure duration or complications.

Rapid Pleurodesis in Patients With Chronic Noninfectious Pleural Effusion: Twenty Years of Real-world Performance Data.

Background: Small cohort studies have shown rapid pleurodesis protocol's (RPP) effectiveness and capacity to expedite pleurodesis for malignant pleural effusion (MPE). This study intends to evaluate the effectiveness of the RPP in inducing pleurodesis in patients with pleural effusions from either malignant or benign etiologies.

Methods: In this single-center, retrospective cohort study spanning 2 decades, we assessed patients with recurrent symptomatic chronic noninfectious pleural effusion, both benign and malignant.

Comparative genomic and immunopathologic analysis of lung adenocarcinomas with and without cytology-proven malignant pleural effusions.

Background: Lung cancer complicated by malignant pleural effusions (MPEs) is associated with significantly increased morbidity and mortality, yet the mechanisms of MPE development remain poorly understood. This study sought to elucidate whether there were specific genomic alterations and/or immunologic biomarkers associated with the presence of MPEs.

Methods: Analysis of comprehensive genomic and immunologic profiling for 275 locally advanced (stage III) or advanced (stage IV) lung adenocarcinomas was subcategorized into cytology-confirmed MPE-positive (MPE+; n = 139 stage IV) and MPE-negative (MPE-; n = 30 stage III + n = 106 stage IV) groups.

Airway Stents for Excessive Central Airway Collapse: A Randomized Controlled Open-label Trial.

Background: Short-term airway stent placement (stent evaluation) has been employed to evaluate whether patients with excessive central airway collapse (ECAC) will benefit from tracheobronchoplasty. Although retrospective studies have explored the impact of stent placement on ECAC, prospective randomized controlled trials are absent.

Methods: This was a randomized open-label trial comparing patients receiving airway stent placement and standard medical treatment (intervention group) versus standard medical treatment alone (control group) for ECAC.

Bronchial rheoplasty for chronic bronchitis: 2-year results from a US feasibility study with RheOx.

Introduction: Chronic bronchitis (CB), a phenotype of chronic obstructive pulmonary disease (COPD) characterised by persistent cough and mucus hypersecretion, is associated with poor outcomes despite guideline-based treatment. Bronchial rheoplasty (BR) with the RheOx system delivers non-thermal pulsed electric fields to the lower airway epithelium and submucosa to reduce mucus producing cells. Early phase clinical trials including 1-year follow-up have demonstrated reduction in airway goblet cell hyperplasia and improvement in CB symptoms.

Sustained Clinical Benefits of Spiration Valve System in Patients with Severe Emphysema: 24-Month Follow-Up of EMPROVE.

Follow-up of patients with emphysema treated with endobronchial valves is limited to 3-12 months after treatment in prior reports. To date, no comparative data exist between treatment and control subjects with a longer follow-up. To assess the durability of the Spiration Valve System (SVS) in patients with severe heterogeneous emphysema over a 24-month period.

The effect of combining different sampling tools on the performance of electromagnetic navigational bronchoscopy for the evaluation of peripheral lung lesions and factors associated with its diagnostic yield.

Background: We assessed the performance of Electromagnetic navigational bronchoscopy (ENB) as a standalone diagnostic technique and the performance of different sampling tools used during the procedure.

Methods: We recruited 160 consecutive patients who underwent ENB for peripheral lung lesions (PLL) at a tertiary care centre. The diagnostic performance of ENB and sampling tools was assessed using a logistic regression model and a ROC-curve in which the dependent variable was diagnostic success.

Impact of an integrated classifier using biomarkers, clinical and imaging factors on clinical decisions making for lung nodules.

Background: An integrated classifier that utilizes plasma proteomic biomarker along with five clinical and imaging factors was previously shown to be potentially useful in lung nodule evaluation. This study evaluated the impact of the integrated proteomic classifier on management decisions in patients with a pretest probability of cancer (pCA) ≤50% in "real-world" clinical setting.

Methods: Retrospective study examining patients with lung nodules who were evaluated using the integrated classifier as compared to standard clinical care during the same period, with at least 1-year follow-up.

Preoperative Workup of Patients With Excessive Central Airway Collapse: Does Stent Evaluation Serve a Role?

Background: Tracheobronchoplasty (TBP) is a definitive anatomic intervention for patients with severe symptomatic expiratory central airway collapse. Although stent evaluations have been described for surgical workup, current literature does not address if improvement during stent evaluation is sustained after TBP. We compared health-related quality of life (HRQOL) and functional status responses after airway stenting to those post-TBP.

Excessive Dynamic Airway Collapse Severity Scoring System: A Call Out for an Overall Severity Determination.

Background: Severe excessive dynamic airway collapse (EDAC) is defined as airway narrowing due to posterior wall protrusion into the airway lumen, >90%. We aimed to establish an overall severity score to assess severe EDAC and the need for subsequent intervention.

Methods: A retrospective study of patients who underwent dynamic bronchoscopy for evaluation of expiratory central airway collapse between January 2019 and July 2021.