Optimal Surgical Approach to Tracheobronchoplasty

Our study reviews the different surgical approach to tracheobronchoplasty (TBP) for treating excessive central airway collapse. While initial treatments focus on supportive care, severe collapse may require surgical intervention. Our comprehensive search aimed to compare open, video-assisted thoracoscopic surgery (VATS), and robotic TBP, examining efficacy, complications, length of stay, operative time, and quality of life. Despite low to moderate evidence quality and challenges in long-term follow-up, our analysis highlights the lack of significant differences in outcomes across surgical techniques. However, the robotic approach tends to result in shorter hospital and ICU stays. Our institution’s use of a short-term stent trial prior to TBP shows promise in enhancing patient selection and outcomes. Given the limited data and the necessity of multidisciplinary care, we underscore the need for standardized outcome measures and recommend incorporating preoperative stent trials to improve prognostication and patient outcomes. Our findings suggest no definitive evidence to favor robotic over open TBP but highlight its potential benefits in terms of recovery metrics.