The role of single use bronchoscopes in central airway obstruction management - an open label randomised controlled trial.

<bold>Introduction:</bold> Single-use flexible bronchoscopes (SUFBs) are being increasingly used worldwide due to reduced risk of infection transmission and lower need for endoscopy staffing. <bold>Aim:</bold> to investigate the role of SUFBs in central airway obstruction (CAO) management. <bold>Methods:</bold> Single centre, open label, randomised controlled trial comparing SUFB (Ambu® aScopeTM 5 Broncho) and videobronchoscopes (VFB) (Olympus BF-1TH190) for bronchoscopic recanalization (BR) in patients with benign and malignant CAO. All procedures were done combining flexible and rigid bronchoscopy. Procedure data, scope performance and user satisfaction parameters were recorded by bronchoscopists. Scope performance, safety and satisfaction were rated on scale of 1-10. <bold>Results:</bold> A total of 20 CAO patients with indication for BR were randomized in 1:1 ratio to SUFB or VFB. Malignant CAO was indication for BR in 14 cases, 8 in SUFB and 6 in VFB group. Average duration of BR in SUFB and VFB were 27,8 and 30,5 minutes (p = 0.698). Laser, electrocautery, balloon and core dilatation were equally used in both groups while stenting was done in 1 case in SUFB group. Bleeding occurred in 7 SUFB and 8 VFB cases (p = 0.61). While there was no difference in operator satisfaction between the groups - 8.5/10 in SUFB and 8.8/10 in VFB group (p = 0.17), there was a significant difference in operator safety scores favouring SUFB (9.7/10) over VFB (8.7/10) (p = 0.002). There were no procedure failures requiring cross over from SUFB to VFB. <bold>Conclusion:</bold> SUFBs had high technical success rates, operator satisfaction and safety levels, providing a feasible alternative to VFBs in interventional bronchoscopic procedures.