Emergent Mediastinal Decompression Technique for Life-Threatening Metastatic Compression Using Osmotic Bio Comminution (OBC)

Purpose: To propose Osmotic Biotic Comminution (OBC), a physical debulking technique for emergency decompression of life-threatening tracheal compression caused by mediastinal metastatic tumors. Description: OBC is performed via a transesophageal double-needle system. Pure water is cyclically injected into the tumor core to induce osmotic cell lysis. Turbid lysate is immediately withdrawn under negative pressure. Key design features include 26°C water to confine diffusion, gravity-assisted progression from the upper pole, and rapid cycles to remove lysates before systemic accumulation. Evaluation: OBC is designed to provide rapid decompression without tumor lysis syndrome risk. The procedure is completed within several tens of minutes, including needle placement, multiple cycles, and imaging confirmation. Conclusions: OBC is an emergency bridging strategy to secure airway patency, buying time for definitive therapy. Animal validation is warranted.