Bronchial balloon dilatation combined with cryotherapy for tuberculous cicatricial central airway stenosis, with Adobe Photoshop for the degree measurement: A multicenter, retrospective study

OBJECTIVE: To explore bronchial balloon dilation (BD) combined with cryotherapy and Photoshop (PS)-base image processing technology in the interventional treatment of tuberculous cicatricial central airway stenosis (CCAS). METHODS: This multicenter, retrospective study analyzed the clinical data of patients with CCAS from six hospitals in Henan, China between June 2019 and October 2022. RESULTS: A total of 307 patients were included, including 152 (62 males) treated with BD alone and 155 (54 males) treated with BD combined with cryotherapy. One month after treatment, compared with the BD group, the total response rate [133 (85.8) vs. 105 (69.1), P < 0.001] and occurrence of restenosis at 1-monthaftertreatment [22 (14.2 %) vs. 47 (30.9 %), P < 0.001] in BD & cryotherapy group were significantly higher; furthermore, the inner diameter of the airway stenosis (8.1 ± 0.9 mm vs. 6.4 ± 1.5 mm, P < 0.001), the cross-sectional area of the airway stenosis (51.6 ± 7.8 mm(2) vs. 33.1 ± 11.6 mm(2), P < 0.001), FEV1 (5.26 ± 0.42 L vs. 4.32 ± 0.31 L, P < 0.001), and PEF (5.72 ± 0.36 L/s vs. 4.56 ± 0.42 L/s, P < 0.001) in BD & cryotherapy group showed significantly more improvements. Moreover, Pearson's correlation analysis showed significantly strong positive correlation (r = 0.818，P < 0.001) between the cross-sectional area of airway stenosis measured by PS-base image processing technology and the inner diameter of airway stenosis measured by chest CT. CONCLUSION: BD combined with cryotherapy for the interventional treatment of CCAS might be superior to BD alone. PS-base image processing technology might be used as a supplement strategy for measuring the degree of central airway stenosis.