Microdebrider – Assisted management of central airway obstruction via rigid bronchoscopy: A preliminary study on safety and efficacy

BACKGROUND: Central Airway Obstruction (CAO) presents a significant challenge in both malignant and benign conditions, requiring urgent intervention. Traditional debulking methods have limitations, prompting the exploration of alternative techniques like the microdebrider, initially used in otolaryngology. Our study, assesses the safety and efficacy of the microdebrider in managing CAO. METHODS: This prospective, non-randomized interventional study included patients with CAO treated using the microdebrider during therapeutic bronchoscopy between February 2023 and January 2024. Data collected included patient demographics, obstruction characteristics, procedural time, and adverse events. The microdebrider was introduced via a rigid bronchoscope, and additional techniques like APC and electrocautery were employed as needed. Five historical control cases were analyzed for comparison. RESULTS: Among 21 cases, 71% were malignant, primarily non-small-cell lung cancer (52.4%). Severe obstructions (>70%) were present in 81% of cases. Post-debulking, the mean obstruction reduced to less than 10%, with 76% categorized as insignificant. The mean procedure time was 28 minutes, with no adverse events observed. Compared to historical controls, microdebrider procedures were faster (28 vs. 51.2 minutes), with lower residual obstruction (10% vs. 20%). CONCLUSIONS: The microdebrider is an effective and economical tool for rapidly re-canalizing severely obstructed airways, particularly in broad-based tumors. It offers advantages over traditional methods, including shorter procedural times and fewer complications. Our study supports the microdebrider's relevance in managing CAO, especially in resource-limited settings.