Laser ablation for bronchial stone induced airway stenosis: a case report

Laser ablation for bronchial stone induced airway stenosis: a case report | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Laser ablation for bronchial stone induced airway stenosis: a case report Huipeng Wang, Xiangwu Zhang, Wei Pu, Tinggeng Tian, Wanling Chen This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4899228/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 3 You are reading this latest preprint version Abstract Broncholithiasis is the presence of calcified substances in the bronchus, usually accompanied by symptoms that cause severe airway irritation or obstruction [1] . Bronchopolithiasis is a rare disease that is most common in areas where tuberculosis and histoplasmosis are prevalent. There are currently no clear guidelines on the treatment options for patients with bronchopolithiasis [3] . We treated a patient with central airway obstruction due to bronchial calculus and tumour growth with remarkable results. The course of treatment is reported as follows. Broncholithiasis Lung neoplasms Central airway obstruction ；Airway stent Tracheomediastinal fistula Figures Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 Figure 7 1 Clinical Data A 57-year-old man presented to our hospital in October 2022 with "dyspnoea with haemoptysis". The patient was diagnosed with T4N3M1b stage IVA squamous cell carcinoma of the right upper lobe by bronchoscopic biopsy and received a straight-tube metal-coated stent implantation. After 5 courses of combined immunotherapy (tirellizumab + paclitaxel + carboplatin), the patient developed stent displacement and tracheomediastinal fistula. After removal of the displaced stent, the patient was lost to follow-up. On 5 June 2023, the patient returned to the hospital for a follow-up visit because of "dyspnoea", which presented as upright breathing and required a nasal oxygen tube for oxygen inhalation. Blood oxygen saturation was only 82% and the CT scan showed that the left main bronchomediastinal fistula had formed (FIGURE 1). Fibreoptic bronchoscopy showed complete obstruction of both main bronchial orifices. The middle and lower lobes of the right lung were patent after removal of the right main bronchial lumen tumour by bronchoscopic cryoablation. The left bronchial obstruction was a naked calcified lymph node that could not be removed by snare or cryoablation. After laser ablation, the left bronchial stones could be completely removed. It was found that the middle and lower segments of the left main bronchus were unobstructed, and the bronchomediastinal fistula was located at the 4th point of the left main bronchus, and a Y-shaped metal-covered stent was to be implanted (as shown in Figure 2-5). Stenting was performed after anti-inflammatory therapy due to high infection index. Post-operative sputum culture showed Klebsiella pneumoniae infection. The patient underwent transbronchoscopic stent implantation on 14 June 2023. A balloon catheter was first used to dilate the trachea, and then a Y-shaped metal-coated stent was placed to completely cover the bronchial fistula (Y-shaped 18*30mm, L: 12*40mm, R: 12*30mm) (as shown in Figure 6-7). After stent placement, the patient's dyspnoea symptoms improved and blood saturation increased. 2 Discussion Bronchial calculi is a rare respiratory disease characterised by the formation of calcified or solidified masses in the bronchial lumen, usually caused by chronic granulomatous disease and chronic inflammation. The main cause of bronchiolitis in China is tuberculosis, and bronchiolitis caused by lung cancer is rare [4] . Common symptoms include cough and haemoptysis, and CT scans can show calcification in the trachea [5] . Tracheomediastinal fistula refers to the abnormal passage between the trachea, bronchus, peripheral airways and mediastinum [6] . Following stent implantation, the patient developed stent dislodgement, stent-associated respiratory infection and bronchomediastinal fistula. Tumour necrosis caused by anti-tumour therapy resulted in abnormal fistulas adjacent to the tumour. Long-term stent compression promoted fistula formation. Chronic airway infection and the anti-angiogenic effect of immunosuppressive drugs lead to non-healing of trachea fistulas [7,8] . Due to Klebsiella infection and the influence of chemotherapy and immunotherapy, the patient developed necrotic inflammation of the subcarinal lymph nodes, calcified lymph nodes penetrated into the trachea through the tracheomediastinal fistula, and later developed bronchial calculi. There are currently no clear guidelines for the treatment of bronchial calculi. It is generally believed that patients with symptoms and complications need to have bronchial stones resected, and bronchoscopic lithotomy is the recommended initial treatment [9] . The literature has shown that laser ablation can crush tracheal calculus without significant tissue damage [10] . In the treatment of this patient, neither cryoablation nor snare resection could remove the bronchial stones, and laser ablation was effective in removing the proliferative bronchial stones. Malignant central airway obstruction refers to obstruction of the trachea or main bronchus complicated by malignant tumours [11] . If the degree of tracheal stenosis is greater than 50%, the patient may experience symptoms of dyspnoea and the primary goal at this time is to protect the patient's ventilatory function [12] . Airway stenting can quickly relieve the symptoms of breathlessness and improve patients' quality of life and survival [13] . The patient was previously implanted with a straight metal stent, which was easily dislodged and exerted strong pressure on the surrounding airway wall, resulting in a tracheomediastinal fistula. The Y-shaped metal-coated stent has the advantages of soft material, good conformability and good sealing [14] . It is particularly suitable for patients with tracheal fistula or necrotic tracheal stenosis at the site of protrusion [15] , and the success rate in treating tracheal fistula and tracheal stenosis can reach 93% [12 ，16] . In the treatment process of this patient, the combination of laser ablation and stent implantation effectively relieved the patient's airway obstruction, but postoperative airway restenosis was highly likely to occur after either laser ablation or stent implantation [17] . In such patients, in addition to regular surveillance, the incidence of post-operative airway restenosis can be reduced by balloon dilatation [17] , local administration of glucocorticoids, laser ablation followed by cryotherapy [18] , drug-eluting stents [19] , radioactive stenting [20] , and intratumoral injection of cisplatin combined with recombinant human endostatin [21] . Declarations Availability of data and materials The datasets used and/or analyzed during the current study are available from the corresponding author upon reasonable request Funding This study was supported by the Research Innovation Team of Thoracic Tumor Prevention and Treatment in Yunnan Province [202405AS350015], the Social Development Project of Yunnan Province Key Research and Development Program [202403AC100015], the Biological Hospital Project of Yunnan Province Major Scientific Research Program [202302AA310020], and the Regional Fund of the National Natural Science Foundation of China [82360562], National Clinical Key Specialty construction Project Supporting fund [zc0021], Yunnan Province Science and Technology Department Kunming Medical University joint special fund project applied basic research [202001AY070001-246]. Ethical Approval The study was conducted in accordance with the Declaration of Helsinki and the study has been approved by the Ethics Committee of Yunnan Cancer Hospital. Participating patients have signed written informed consent. References GALLUCCIO G, TRAMAGLINO L M, MARCHESE R, 等. Competence in operative bronchoscopy[J/OL]. Panminerva Medica, 2019, 61(3): 298-325. DOI:10.23736/S0031-0808.19.03602-4. Alshabani K, Ghosh S, Arrossi AV, Mehta AC. Broncholithiasis: A Review. Chest. 2019;156(3):445-455. doi:10.1016/j.chest.2019.05.012 ALSHABANI K, GHOSH S, ARROSSI A V, 等. Broncholithiasis[J/OL]. Chest, 2019, 156(3): 445-455. DOI:10.1016/j.chest.2019.05.012. HU S, YANG X, HUANG Y, 等. Asymptomatic Broncholithiasis and Aspergillus Infection: A Case Report and Literature Review[J/OL]. Infection and Drug Resistance, 2023, Volume 16: 2911-2919. DOI:10.2147/IDR.S410155. He R, Zhou H, Jiang M, Lv X, Meng J. Broncholithiasis: Treatment Evaluation in 63 Patients. Am J Med Sci. 2022;363(4):351-358. doi:10.1016/j.amjms.2021.05.028 Lao Miao-Chan, GAO Xinglin, GUO Ji-Quan, Chen Ping-ping, CUI Jing-HUA, GAO Ping. After chemotherapy - mediastinal tracheal/bronchial fistula case analysis and literature [J]. International journal of breathing, 2021 9 (2) : 149-153. The DOI: 10.3760 / cma. J.c. n131368-20200115-00019. Miñambres E, Burón J, Ballesteros MA, Llorca J, Muñoz P, González-Castro A. Tracheal rupture after endotracheal intubation: a literature systematic review. Eur J Cardiothorac Surg. 2009;35(6):1056-1062. doi:10.1016/j.ejcts.2009.01.053 Nishie K, Yasuo M, Kitaguchi Y, et al. Bevacizumab-induced tracheoesophageal fistula in a patient suffering from lung cancer with bulky subcarinal lymph node: a case report. Nagoya J Med Sci. 2018;80(1):129-134. doi:10.18999/nagjms.80.1.129 HE R, ZHOU H, JIANG M, 等. Broncholithiasis: Treatment Evaluation in 63 Patients[J/OL]. The American Journal of the Medical Sciences, 2022, 363(4): 351-358. DOI:10.1016/j.amjms.2021.05.028. CHENG Y, WANG G, ZHANG W, 等. Feasibility and long-term safety of Ho:YAG laser lithotripsy in broncholithiasis patients[J/OL]. BMC Pulmonary Medicine, 2021, 21(1): 81. DOI:10.1186/s12890-021-01407-8. GAFFORD J B, WEBSTER S, DILLON N, 等. A Concentric Tube Robot System for Rigid Bronchoscopy: A Feasibility Study on Central Airway Obstruction Removal[J/OL]. Annals of Biomedical Engineering, 2020, 48(1): 181-191. DOI:10.1007/s10439-019-02325-x. JIN F, LI Q, LI S, 等. Interventional Bronchoscopy for the Treatment of Malignant Central Airway Stenosis: An Expert Recommendation for China[J/OL]. Respiration; International Review of Thoracic Diseases, 2019, 97(5): 484-494. DOI:10.1159/000497213. SERINO M, FREITAS C, SALEIRO S, 等. Airway stents in malignant central airway obstruction[J/OL]. Pulmonology, 2021, 27(5): 466-469. DOI:10.1016/j.pulmoe.2021.02.003. GUIBERT N, HÉLUAIN V, BRINDEL A, 等. [Airway stenting: State of the art][J/OL]. Revue Des Maladies Respiratoires, 2022, 39(5): 477-485. DOI:10.1016/j.rmr.2022.02.059. GUIBERT N, SAKA H, DUTAU H. Airway stenting: Technological advancements and its role in interventional pulmonology[J/OL]. Respirology (Carlton, Vic.), 2020, 25(9): 953-962. DOI:10.1111/resp.13801. USUDA K, IWAI S, YAMAGATA A, 等. Clinical outcomes and survival following placement of self-expandable metallic stents for central airway stenosis and fistula[J/OL]. Thoracic Cancer, 2021, 12(1): 48-56. DOI:10.1111/1759-7714.13707. LI J, ZHOU Y, LIU Z, 等. Multimodality Endoscopic Approach for Benign Central Airway Stenosis in Pediatric Tuberculosis: A Case Report[J/OL]. Risk Management and Healthcare Policy, 2023, 16: 225-229. DOI:10.2147/RMHP.S390214. ZHANG L, YUAN S, PAN C, 等. Outcomes of Holmium Laser, Cryoablation, and Budesonide Inhalation for Treating Severe Central Airway Stenosis in Infants[J/OL]. Journal of Investigative Surgery: The Official Journal of the Academy of Surgical Research, 2023, 36(1): 2257792. DOI:10.1080/08941939.2023.2257792. ARAVENA C, GILDEA T R. Advancements in airway stents: a comprehensive update[J/OL]. Current Opinion in Pulmonary Medicine, 2024, 30(1): 75-83. DOI:10.1097/MCP.0000000000001032. KE M, ZENG J, CHEN Z, 等. Stent loaded with radioactive Iodine-125 seeds for adenoid cystic carcinoma of central airway: A case report of innovative brachytherapy[J/OL]. Frontiers in Oncology, 2023, 13: 837394. DOI:10.3389/fonc.2023.837394. ZHOU Y, GAO Y, ZHANG N, 等. Clinical effects of cisplatin plus recombinant human endostatin (rh-endostatin) intratumoral injection on malignant central airway obstruction: a retrospective analysis of 319 cases[J/OL]. Journal of Thoracic Disease, 2021, 13(2): 1100-1105. DOI:10.21037/jtd-20-1493. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Editor assigned by journal 17 Aug, 2024 Submission checks completed at journal 15 Aug, 2024 First submitted to journal 12 Aug, 2024 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4899228","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":341687769,"identity":"82ebbee6-6cc1-40b7-af3f-68aaae568f98","order_by":0,"name":"Huipeng Wang","email":"","orcid":"","institution":"Yunnan Cancer Hospital","correspondingAuthor":false,"prefix":"","firstName":"Huipeng","middleName":"","lastName":"Wang","suffix":""},{"id":341687770,"identity":"5f539d59-b9f3-479f-a972-ec06b6f4e3db","order_by":1,"name":"Xiangwu Zhang","email":"","orcid":"","institution":"Yunnan Cancer 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formation\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-4899228/v1/0aade702425943862648d119.png"},{"id":66584135,"identity":"c307bae9-7118-4c54-a846-e5d16cb7d5c5","added_by":"auto","created_at":"2024-10-14 14:08:03","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":52769,"visible":true,"origin":"","legend":"\u003cp\u003eEndogenetic growth of the tumor in the right main bronchus\u003c/p\u003e","description":"","filename":"3.png","url":"https://assets-eu.researchsquare.com/files/rs-4899228/v1/134bb954fd6dcb7c364185b2.png"},{"id":66587194,"identity":"f32290f7-5a2d-4566-9ead-9e6e6313a50b","added_by":"auto","created_at":"2024-10-14 14:24:03","extension":"png","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":52204,"visible":true,"origin":"","legend":"\u003cp\u003eExposed lymph nodes with calcified left main bronchus\u003c/p\u003e","description":"","filename":"4.png","url":"https://assets-eu.researchsquare.com/files/rs-4899228/v1/0bfb6bbec1390eeaf2777401.png"},{"id":66586016,"identity":"5b2fe961-abe6-4022-b5d3-ff9657bbb5ff","added_by":"auto","created_at":"2024-10-14 14:16:03","extension":"png","order_by":5,"title":"Figure 5","display":"","copyAsset":false,"role":"figure","size":45817,"visible":true,"origin":"","legend":"\u003cp\u003eAfter laser ablation of prominences\u003c/p\u003e","description":"","filename":"5.png","url":"https://assets-eu.researchsquare.com/files/rs-4899228/v1/4c7839d05c0c0c3d007d1a33.png"},{"id":66584138,"identity":"c34b3da4-d664-4796-9e15-1a7838591a99","added_by":"auto","created_at":"2024-10-14 14:08:03","extension":"png","order_by":6,"title":"Figure 6","display":"","copyAsset":false,"role":"figure","size":85871,"visible":true,"origin":"","legend":"\u003cp\u003eMediastinal fistula opening of the left main bronchial airway\u003c/p\u003e","description":"","filename":"6.png","url":"https://assets-eu.researchsquare.com/files/rs-4899228/v1/c01c6a802ef398a7ca9c4bdf.png"},{"id":66584140,"identity":"e22a1caf-1b36-440d-b708-33d53c5a8244","added_by":"auto","created_at":"2024-10-14 14:08:03","extension":"png","order_by":7,"title":"Figure 7","display":"","copyAsset":false,"role":"figure","size":89847,"visible":true,"origin":"","legend":"\u003cp\u003eAfter the support is placed\u003c/p\u003e","description":"","filename":"7.png","url":"https://assets-eu.researchsquare.com/files/rs-4899228/v1/859ebaa561fe8981a52c3e6f.png"},{"id":66587359,"identity":"7933f87d-212b-4400-9a5b-3918aa21282f","added_by":"auto","created_at":"2024-10-14 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The patient was diagnosed with T4N3M1b stage IVA squamous cell carcinoma of the right upper lobe by bronchoscopic biopsy and received a straight-tube metal-coated stent implantation. After 5 courses of combined immunotherapy (tirellizumab + paclitaxel + carboplatin), the patient developed stent displacement and tracheomediastinal fistula. After removal of the displaced stent, the patient was lost to follow-up.\u003c/p\u003e\n\u003cp\u003eOn 5 June 2023, the patient returned to the hospital for a follow-up visit because of \u0026quot;dyspnoea\u0026quot;, which presented as upright breathing and required a nasal oxygen tube for oxygen inhalation. Blood oxygen saturation was only 82% and the CT scan showed that the left main bronchomediastinal fistula had formed (FIGURE 1).\u003c/p\u003e\n\u003cp\u003eFibreoptic bronchoscopy showed complete obstruction of both main bronchial orifices. The middle and lower lobes of the right lung were patent after removal of the right main bronchial lumen tumour by bronchoscopic cryoablation. The left bronchial obstruction was a naked calcified lymph node that could not be removed by snare or cryoablation. After laser ablation, the left bronchial stones could be completely removed. It was found that the middle and lower segments of the left main bronchus were unobstructed, and the bronchomediastinal fistula was located at the 4th point of the left main bronchus, and a Y-shaped metal-covered stent was to be implanted (as shown in Figure 2-5). Stenting was performed after anti-inflammatory therapy due to high infection index. Post-operative sputum culture showed Klebsiella pneumoniae infection.\u003c/p\u003e\n\u003cp\u003eThe patient underwent transbronchoscopic stent implantation on 14 June 2023. A balloon catheter was first used to dilate the trachea, and then a Y-shaped metal-coated stent was placed to completely cover the bronchial fistula (Y-shaped 18*30mm, L: 12*40mm, R: 12*30mm) (as shown in Figure 6-7). After stent placement, the patient\u0026apos;s dyspnoea symptoms improved and blood saturation increased.\u003c/p\u003e"},{"header":"2 Discussion","content":"\u003cp\u003eBronchial calculi is a rare respiratory disease characterised by the formation of calcified or solidified masses in the bronchial lumen, usually caused by chronic granulomatous disease and chronic inflammation. The main cause of bronchiolitis in China is tuberculosis, and bronchiolitis caused by lung cancer is rare \u003csup\u003e[4]\u003c/sup\u003e. Common symptoms include cough and haemoptysis, and CT scans can show calcification in the trachea \u003csup\u003e[5]\u003c/sup\u003e. Tracheomediastinal fistula refers to the abnormal passage between the trachea, bronchus, peripheral airways and mediastinum \u003csup\u003e[6]\u003c/sup\u003e. Following stent implantation, the patient developed stent dislodgement, stent-associated respiratory infection and bronchomediastinal fistula. Tumour necrosis caused by anti-tumour therapy resulted in abnormal fistulas adjacent to the tumour. Long-term stent compression promoted fistula formation. Chronic airway infection and the anti-angiogenic effect of immunosuppressive drugs lead to non-healing of trachea fistulas \u003csup\u003e[7,8]\u003c/sup\u003e. Due to Klebsiella infection and the influence of chemotherapy and immunotherapy, the patient developed necrotic inflammation of the subcarinal lymph nodes, calcified lymph nodes penetrated into the trachea through the tracheomediastinal fistula, and later developed bronchial calculi.\u003c/p\u003e\n\u003cp\u003eThere are currently no clear guidelines for the treatment of bronchial calculi. It is generally believed that patients with symptoms and complications need to have bronchial stones resected, and bronchoscopic lithotomy is the recommended initial treatment \u003csup\u003e[9]\u003c/sup\u003e. The literature has shown that laser ablation can crush tracheal calculus without significant tissue damage \u003csup\u003e[10]\u003c/sup\u003e. In the treatment of this patient, neither cryoablation nor snare resection could remove the bronchial stones, and laser ablation was effective in removing the proliferative bronchial stones.\u003c/p\u003e\n\u003cp\u003eMalignant central airway obstruction refers to obstruction of the trachea or main bronchus complicated by malignant tumours \u003csup\u003e[11]\u003c/sup\u003e. If the degree of tracheal stenosis is greater than 50%, the patient may experience symptoms of dyspnoea and the primary goal at this time is to protect the patient's ventilatory function \u003csup\u003e[12]\u003c/sup\u003e. Airway stenting can quickly relieve the symptoms of breathlessness and improve patients' quality of life and survival \u003csup\u003e[13]\u003c/sup\u003e. The patient was previously implanted with a straight metal stent, which was easily dislodged and exerted strong pressure on the surrounding airway wall, resulting in a tracheomediastinal fistula. The Y-shaped metal-coated stent has the advantages of soft material, good conformability and good sealing \u003csup\u003e[14]\u003c/sup\u003e. It is particularly suitable for patients with tracheal fistula or necrotic tracheal stenosis at the site of protrusion \u003csup\u003e[15]\u003c/sup\u003e, and the success rate in treating tracheal fistula and tracheal stenosis can reach 93%\u003csup\u003e[12\u003c/sup\u003e\u003csup\u003e，16]\u003c/sup\u003e.\u003c/p\u003e\n\u003cp\u003eIn the treatment process of this patient, the combination of laser ablation and stent implantation effectively relieved the patient's airway obstruction, but postoperative airway restenosis was highly likely to occur after either laser ablation or stent implantation \u003csup\u003e[17]\u003c/sup\u003e. In such patients, in addition to regular surveillance, the incidence of post-operative airway restenosis can be reduced by balloon dilatation \u003csup\u003e[17]\u003c/sup\u003e, local administration of glucocorticoids, laser ablation followed by cryotherapy \u003csup\u003e[18]\u003c/sup\u003e, drug-eluting stents \u003csup\u003e[19]\u003c/sup\u003e, radioactive stenting \u003csup\u003e[20]\u003c/sup\u003e, and intratumoral injection of cisplatin combined with recombinant human endostatin \u003csup\u003e[21]\u003c/sup\u003e.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003eAvailability of data and materials\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe datasets used and/or analyzed during the current study are available from the corresponding author upon reasonable request\u003c/p\u003e\n\u003cp\u003eFunding\u003c/p\u003e\n\u003cp\u003eThis study was supported by the Research Innovation Team of Thoracic Tumor Prevention and Treatment in Yunnan Province [202405AS350015], the Social Development Project of Yunnan Province Key Research and Development Program [202403AC100015], the Biological Hospital Project of Yunnan Province Major Scientific Research Program [202302AA310020], and the Regional Fund of the National Natural Science Foundation of China [82360562], National Clinical Key Specialty construction Project Supporting fund [zc0021], Yunnan Province Science and Technology Department Kunming Medical University joint special fund project applied basic research [202001AY070001-246].\u003c/p\u003e\n\u003cp\u003eEthical Approval\u003c/p\u003e\n\u003cp\u003eThe study was conducted in accordance with the Declaration of Helsinki and the study has been approved by the Ethics Committee of Yunnan Cancer Hospital. Participating patients have signed written informed consent.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n \u003cli\u003eGALLUCCIO G, TRAMAGLINO L M, MARCHESE R, 等. Competence in operative bronchoscopy[J/OL]. Panminerva Medica, 2019, 61(3): 298-325. DOI:10.23736/S0031-0808.19.03602-4.\u003c/li\u003e\n \u003cli\u003eAlshabani K, Ghosh S, Arrossi AV, Mehta AC. Broncholithiasis: A Review. Chest. 2019;156(3):445-455. doi:10.1016/j.chest.2019.05.012\u003c/li\u003e\n \u003cli\u003eALSHABANI K, GHOSH S, ARROSSI A V, 等. Broncholithiasis[J/OL]. Chest, 2019, 156(3): 445-455. DOI:10.1016/j.chest.2019.05.012.\u003c/li\u003e\n \u003cli\u003eHU S, YANG X, HUANG Y, 等. Asymptomatic Broncholithiasis and Aspergillus Infection: A Case Report and Literature Review[J/OL]. Infection and Drug Resistance, 2023, Volume 16: 2911-2919. DOI:10.2147/IDR.S410155.\u003c/li\u003e\n \u003cli\u003eHe R, Zhou H, Jiang M, Lv X, Meng J. Broncholithiasis: Treatment Evaluation in 63 Patients. 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Nagoya J Med Sci. 2018;80(1):129-134. doi:10.18999/nagjms.80.1.129\u003c/li\u003e\n \u003cli\u003eHE R, ZHOU H, JIANG M, 等. Broncholithiasis: Treatment Evaluation in 63 Patients[J/OL]. The American Journal of the Medical Sciences, 2022, 363(4): 351-358. DOI:10.1016/j.amjms.2021.05.028.\u003c/li\u003e\n \u003cli\u003eCHENG Y, WANG G, ZHANG W, 等. Feasibility and long-term safety of Ho:YAG laser lithotripsy in broncholithiasis patients[J/OL]. BMC Pulmonary Medicine, 2021, 21(1): 81. DOI:10.1186/s12890-021-01407-8.\u003c/li\u003e\n \u003cli\u003eGAFFORD J B, WEBSTER S, DILLON N, 等. A Concentric Tube Robot System for Rigid Bronchoscopy: A Feasibility Study on Central Airway Obstruction Removal[J/OL]. Annals of Biomedical Engineering, 2020, 48(1): 181-191. DOI:10.1007/s10439-019-02325-x.\u003c/li\u003e\n \u003cli\u003eJIN F, LI Q, LI S, 等. Interventional Bronchoscopy for the Treatment of Malignant Central Airway Stenosis: An Expert Recommendation for China[J/OL]. 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DOI:10.21037/jtd-20-1493.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"respiratory-research","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"rere","sideBox":"Learn more about [Respiratory Research](http://respiratory-research.biomedcentral.com/)","snPcode":"12931","submissionUrl":"https://submission.nature.com/new-submission/12931/3","title":"Respiratory Research","twitterHandle":"@RespiratoryBMC","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Broncholithiasis, Lung neoplasms, Central airway obstruction ；Airway stent, Tracheomediastinal fistula","lastPublishedDoi":"10.21203/rs.3.rs-4899228/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4899228/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eBroncholithiasis is the presence of calcified substances in the bronchus, usually accompanied by symptoms that cause severe airway irritation or obstruction\u003csup\u003e[1]\u003c/sup\u003e. Bronchopolithiasis is a rare disease that is most common in areas where tuberculosis and histoplasmosis are prevalent. There are currently no clear guidelines on the treatment options for patients with bronchopolithiasis\u003csup\u003e[3]\u003c/sup\u003e. We treated a patient with central airway obstruction due to bronchial calculus and tumour growth with remarkable results. The course of treatment is reported as follows.\u003c/p\u003e","manuscriptTitle":"Laser ablation for bronchial stone induced airway stenosis: a case report","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-10-14 14:07:58","doi":"10.21203/rs.3.rs-4899228/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"editorAssigned","content":"","date":"2024-08-17T11:37:23+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2024-08-15T14:01:00+00:00","index":"","fulltext":""},{"type":"submitted","content":"Respiratory Research","date":"2024-08-12T09:22:15+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"respiratory-research","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"rere","sideBox":"Learn more about [Respiratory Research](http://respiratory-research.biomedcentral.com/)","snPcode":"12931","submissionUrl":"https://submission.nature.com/new-submission/12931/3","title":"Respiratory Research","twitterHandle":"@RespiratoryBMC","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"156329ea-c574-4f3d-927b-683d5a6f010c","owner":[],"postedDate":"October 14th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2024-10-14T14:07:58+00:00","versionOfRecord":[],"versionCreatedAt":"2024-10-14 14:07:58","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4899228","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4899228","identity":"rs-4899228","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}