Background: Airway stenosis is a potentially life-threatening condition that often requires endoscopic intervention to maintain airway patency. Silicone stents are widely used in benign and selected malignant stenoses; however, their placement is frequently associated with adverse events. Despite increasing use in Mexico and Latin America, institutional data describing complication patterns and associated imaging findings remain limited. This study aimed to describe the complications associated with silicone airway stents, as well as their clinical, technical, and tomographic characteristics in a single-center experience. Methods: We conducted an observational, descriptive, retrospective study at the National Institute of Respiratory Diseases, Mexico City. Adult patients with subglottic or central airway stenosis who underwent silicone stent placement between January 2019 and January 2025 and developed at least one stent-related complication during follow-up were included. Demographic, clinical, technical, and imaging variables were analyzed. Complications were defined as any stent-or procedure-related adverse event requiring bronchoscopic intervention, stent replacement, or specific therapeutic management. Chest computed tomography (CT) findings were descriptively correlated with bronchoscopic findings in clinically indicated evaluations. Results: Twenty-three patients with silicone stents who developed at least one complication met the inclusion criteria. The median age was 42 years [interquartile range (IQR), 34-53 years], and 60.9% were women. The mean BMI was 26.8 kg/m2. The most frequent comorbidities were systemic arterial hypertension (13.0%), obesity (30.4%), and type 2 diabetes mellitus (17.4%). Post-intubation stenosis was the most frequent etiology (52.2%), followed by autoimmune disease (30.4%). A total of 171 complication events were recorded. Granulation tissue formation was the most frequent event (78.3%), followed by mucus plugging (73.9%) and stent migration (47.8%). Among 124 chest CT examinations performed for acute symptoms or scheduled follow-up, tomographic findings were concordant with bronchoscopy in event-driven evaluations. Air pockets between the stent and airway wall were identified in five clinically stable patients who subsequently developed migration. Conclusions: Among patients who developed complications after silicone airway stent placement, adverse events were frequent and occurred early during follow-up. Chest CT showed high agreement with bronchoscopy in clinically indicated assessments and may serve as a complementary, non-invasive tool for evaluating stent-related complications. The presence of air pockets may represent an early radiologic finding preceding migration; however, this observation should be considered hypothesis-generating.

Background and Objective:Personalized medicine tailors interventions to a patient's unique anatomy and physiology. Three-dimensional printing (3DP) enables this precision for complex airway disease, including tracheal stenosis, tracheobronchomalacia, aerodigestive fistulas, and segmental defects, where conventional silicone or metallic stents and surgical reconstruction often fail to provide durable, anatomically congruent solutions. Tissue engineering and 3DP promise patient-specific devices and regenerative scaffolds that maintain patency, resist collapse, and minimize immunogenicity. This review synthesizes clinical and preclinical progress, highlighting materials, design strategies, biologic integration, and translational barriers. Methods:A comprehensive literature search was conducted in PubMed (January 1, 2015-June 1, 2025). Inclusion criteria encompassed studies utilizing 3DP to fabricate implantable devices for tracheobronchial reconstruction, with in vivo implantation. Pediatric (<18 years), egg/mouse/rat preclinical studies, review articles, and abstracts were excluded. Data extracted included publication details, participant characteristics, device materials and printing methods, and outcomes. Key Content and Findings:From 808 records, 16 clinical and 56 preclinical studies were analyzed. Clinically, indirect 3DP with silicone or metallic alloys predominated, creating Y-stents or straight stents for post-lung transplant (LTx) stenosis, tracheobronchomalacia, granulomatosis with polyangiitis, malignant obstruction, and aerodigestive fistulas. 3DP technologies facilitate the synthesis of customized stents that can better conform to individual airway geometries, offering more precise therapeutic options than conventional one-size-fits-all devices. In parallel, preclinical studies aim to address the limitations observed within clinical settings by focusing on long-term, regenerative solutions. Preclinical studies focused on biodegradable scaffolds, commonly polycaprolactone (PCL), enhanced through surface modification or hybridization with hydrogels such as gelatin methacryloyl (GelMA) or silk fibroin and bioactive factors like transforming growth factor-β (TGF-β) or stromal cell-derived factor-1 (SDF-1). Bilayer constructs with epithelial and chondrogenic components supported epithelialization, cartilage formation, and vascularization. Advanced strategies such as exosome use, ferroptosis inhibition, and heterotopic preconditioning improved integration. Conclusions:3DP enables anatomically tailored airway implants and promising regenerative scaffolds. Translation is limited by technical variability, regulatory complexity, and sparse long-term data. Standardized protocols, rigorous trials, and multidisciplinary collaboration are essential to bring 3DP airway reconstruction into clinical practice.

RATIONALE:Endobronchial ultrasound (EBUS)-guided sampling for evaluation of benign conditions and lymphoma is not standardized. Sampling methods remain under study as new tools become available. METHODS:We performed a single-center study with protocolized sampling and processing to evaluate the diagnostic yield of transbronchial needle aspiration (TBNA), Franseen needle biopsy (transbronchial needle biopsy [TBNB]), and cryobiopsy in patients with mediastinal and hilar abnormality with concern for sarcoid, lymphoma, or undifferentiated lymphadenopathy. Following TBNA, exploratory sampling was performed. A tract was created with a TBNB needle pass followed by cryobiopsy. Sampling was subsequently alternated for a total of 3 passes per tool. The primary outcome was diagnostic yield, using a strict criterion modeled from recent American Thoracic Society/American College of Chest Physicians guidelines. Secondary outcomes included procedural outcomes and pathologic assessment of TBNB and cryobiopsy samples. RESULTS:Between January and December 2024, 56 nodes were sampled in 51 patients. Diagnostic yield per node was 86% (48/56). Regarding individual tools, the yield was 50% for TBNA, 73% for TBNB, and 82% for cryobiopsy (TBNA vs cryobiopsy, P = .0001; TBNA vs TBNB, P = .006; TBNB vs cryobiopsy, P = .13). In subgroup analysis, TBNB and cryobiopsy enhanced diagnostic yield in benign conditions (TBNA [59%], TBNB [88%], and cryobiopsy [100%]; TBNA vs cryobiopsy, P = .002; TBNA vs TBNB, P = .01; TBNB vs cryobiopsy, P = .11). For lymphoma, the diagnostic yield per node was 3/10 for TBNA, 5/10 for TBNB, and 6/10 for cryobiopsy (TBNA vs cryobiopsy, P = .001; TBNA vs TBNB, P = .1; TBNB vs cryobiopsy, P = .1). Upon pathology review, TBNB provided larger samples compared to cryobiopsy but TBNB samples contained a larger proportion of blood; these differences translated to similar resultant areas of diagnostic tissue for both tools. Sample usage for immunohistochemistry and special staining was higher for cryobiopsy (61%) vs TBNB (33%). Study sampling was feasible in all patients with a 2% complication rate (1 pneumothorax). CONCLUSIONS:Both TBNB and cryobiopsy enhance the diagnostic yield of EBUS-TBNA in benign conditions. Multiple passes with 3 biopsy tools at an individual lymph node is safe and feasible. Cryobiopsy provides superior sample quality relative to TBNB and superior yield vs TBNA in lymphoma.

Primary pulmonary lymphomas (PPLs) are rare clinical entities representing 0.5%-1% of all pulmonary neoplasms, of which mucosa-associated lymphoid tissue (MALT) lymphoma is the most common type (80%). PPLs are traditionally considered challenging to diagnose bronchoscopically given the rarity of these entities, small sample sizes, and the ancillary testing often required to adequately differentiate them from benign intraparenchymal lymph nodes. Here, we report three cases of pulmonary MALT lymphomas. In two cases, the patients presented with pulmonary nodules and were diagnosed by robotic-assisted bronchoscopy following prior nondiagnostic biopsy attempts. The third patient presented with distal tracheal thickening, where flexible bronchoscopy revealed a particularly rare case of MALT lymphoma with endobronchial involvement.

BACKGROUND:Transbronchial cryobiopsy has expanded beyond its established role in interstitial lung disease, driven by release of single-use cryoprobes, most notably the 1.1 mm cryoprobe. As use of transbronchial cryobiopsy accelerates across non-interstitial lung disease diagnostic contexts, practice variability has outpaced evidence generation and formal guidance. RESEARCH QUESTION:What are areas of clinical consensus regarding indications, tools, techniques, specimen handling, safety considerations, and requisite procedural expertise for the use of the 1.1 mm cryoprobe in non-interstitial lung disease transbronchial cryobiopsy, including convex-probe endobronchial ultrasound-guided and peripheral pulmonary lesion sampling. STUDY DESIGN AND METHODS:An international panel of bronchoscopy experts was assembled through the Interventional Pulmonology Outcomes Group. Following a structured evidence review, a modified Delphi methodology was conducted, consisting of an initial round of open-ended questions followed by 3 rounds in which panelists rated their agreement with statements on a 5-point Likert scale. Consensus was defined a priori as ≥ 80% agreement. Domains included: (1) peripheral transbronchial cryobiopsy, (2) convex-probe endobronchial ultrasound-guided cryobiopsy, (3) airway, anesthesia, and complication management, and (4) specimen handling and processing. RESULTS:A total of 32 physicians participated in this project. The modified Delphi process consisted of 4 survey rounds conducted between May and November 2025. Consensus was obtained on 31 statements. No consensus was obtained on 17 statements. INTERPRETATION:To our knowledge, this Delphi statement represents the first expert guidance for non-interstitial lung disease applications of both endobronchial ultrasound-guided and peripheral transbronchial cryobiopsy. The consensus statements delineate contemporary best practices, bridge critical gaps in standardization, and outline domains where further research is needed.

Background: Prolonged mechanical ventilation and tracheostomy in patients with COVID-19 is associated with longer hospital stays. Guidance on which patients are at risk for tracheostomy due to the progression of COVID-19 is limited. Objectives: This study aimed to identify risk factors associated with the need for tracheostomy in patients intubated for COVID-19 between 1 March and 31 December 2020. Methods: The methodology for this study involved a single-center retrospective analysis of 120 patients who were intubated due to COVID-19 infection between 1 March 2020 and 31 December 2020. A comparison of variables was performed using the Wilcoxon test, Chi-squared test, and Fisher's exact test alongside univariate analysis. Results: Several risk factors were found to be significantly associated with the need for tracheostomy, including age, P/F ratio, creatinine level, and history of arrhythmia. Conclusions: Initial exploration indicates the presence of certain factors that can help us understand future need for tracheostomy earlier in the patient's clinical course. Further analysis should be performed with a larger sample size to validate these findings and increase the generalizability of the present study.

RATIONALE:Guidelines recommend nonsurgical biopsy for indeterminate pulmonary lesions >8 mm. Shape-sensing robotic-assisted bronchoscopy (ssRAB) is growing in use to biopsy small pulmonary nodules; however, current literature is limited to single-center studies with limited follow-up. OBJECTIVES:This study, PRECIsE, assessed safety and performance of the first ssRAB iteration across multiple sites and nascent users. METHODS:This was a prospective, multicenter, observational study evaluating ssRAB without cone-beam computed tomography guidance in patients with nodules 10 to 30 mm located in or beyond the sub-segmental airways. Patients were followed for 2 years; the primary endpoint was sensitivity for malignancy with diagnostic yield, and safety as secondary endpoints. Multilevel logistic regression models were used to control for factors associated with sensitivity and diagnostic yield. RESULTS:A total of 305 procedures were performed across 6 centers. Median nodule size was 17.0 mm (IQR, 14.0-23.0) with bronchus sign present in 37% of cases. Sensitivity for malignancy through 2 years was 81.3% (95% CI, 75.7%-86.1%). Multilevel modeling demonstrated that female sex, smaller nodule size, lower lobe location, semi-solid density, and higher body mass index were associated with lower sensitivity. Diagnostic yield was 74.1% (95% CI, 68.8%-78.9%) according to the American Thoracic Society/American College of Chest Physicians (ATS/ACCP) criteria and 77.5% (95% CI, 72.4%-81.8%) according to the intermediate criteria. Multilevel modeling demonstrated a nonsignificant site/center-level effect on ATS/ACCP diagnostic yield (P = .36). Pneumothorax requiring intervention was 1.6% (5/305); bleeding was 1.0% (3/305) with 2 Nashville grade 2 events and one Nashville grade 3 event. CONCLUSIONS:The first iteration of ssRAB demonstrated encouraging performance and a strong safety profile among nascent users for the biopsy of small peripheral nodules.

BACKGROUND:Expiratory central airway collapse (ECAC) is caused by anterior displacement of the posterior membrane (EDAC) or weakening of the cartilaginous walls (TBM). Differentiating the 2 is challenging, resulting in misdiagnosis and missed opportunities for patients. We investigated how accurately providers identify each pathology on computed tomographic (CT) images. METHODS:Images from 100 patients who underwent tracheobronchoplasty (TBP) were reviewed by 4 airway experts and categorized into TBM, EDAC, normal airway, or unknown by majority consensus. Selected images of patients with TBM (n=9) and EDAC (n=9) were distributed to respondents. Linear regression was used to investigate overall accuracy; inter-rater agreement was measured using Fleiss' kappa (κ). RESULTS:We recruited 35 surgeons and 35 pulmonologists. Most practiced at an academic center (68.5%) and cared for patients with ECAC (61.4%). Among surgeons, 14 (40.0%) performed ≥5 complex airway cases yearly, and 13 (37.1%) performed TBP. Only 1 (1.5%) assigned the correct diagnosis to all 18 patients, while 13 (18.6%) identified <50.0% of the correct diagnoses. Inter-rater agreement for respondents was low (κ=0.21; 95% CI: 0.17-0.30; P<0.01). Predictors of accuracy included ≥10 years in practice (β=0.49; 95% CI: 0.03-0.95; P=0.03) and practicing pulmonology (β=0.72; 95% CI: 0.15-1.29; P=0.02). CONCLUSION:Distinguishing EDAC and TBM is challenging, with poor agreement among clinicians. Therefore, clinicians should consider referring any patient with ECAC early for multidisciplinary evaluation.

BACKGROUND:Short-term airway stenting is performed in patients with severe excessive central airway collapse (ECAC) to assess whether airway stabilization leads to symptomatic improvement thereby supporting surgical management. Interpretation of stent trials, however, may be confounded by complications such as bacterial colonization and granulation tissue formation. METHODS:Retrospective review of patients who underwent airway stenting at our institution between 2016 and 2022. We assessed the incidence of airway bacterial colonization, defined as conversion from a negative pre-stent to a positive post-stent bronchial wash (BW) culture, and the development of granulation tissue 7-14 days after stent placement, as well as their correlation with clinical outcomes. RESULTS:Pre- and post-stent bronchial washings were available from 101 stent trials. Airway bacterial colonization was observed in 40% of cases, with S.aureus accounting for 79%. Granulation tissue developed in 63% of cases, and it was significantly more frequent in silicone stents compared to Uncovered Self-Expanding Metallic Airway Stents (USEMAS) (odds ratio [OR] = 16; 95% CI, 1.6-166.7, P = .02). It was also more frequent in patients with positive post-stent BW (adjusted OR = 2.6; 95% CI, 0.9-6.6, P = 0.05) and in cases of early colonization (adjusted OR = 2.98; 95% CI, 0.9-9.5, P = 0.065). Although colonization and granulation tissue occurred more frequently in patients with no clinical improvement, neither was independently associated with increased odds of a negative stent trial. CONCLUSIONS:Bacterial colonization, particularly with S. aureus, occurs early after stent deployment and is associated with granulation tissue formation. However, these complications did not significantly affect clinical stent trial outcomes.

Over the past two decades, significant advances in minimally invasive diagnostics and therapeutics have catalyzed subspecialization in pulmonary and thoracic disciplines. Interventional pulmonology (IP) has expanded the bronchoscopic management of complex airway disease, emphysema, lung cancer, and pleural pathology, while thoracic surgery (TS) continues to provide definitive operative therapies. As the diagnostic and therapeutic boundaries between these fields overlap, a coordinated multidisciplinary team (MDT) structure is warranted to optimize patient selection, reduce delays to efficient care, and offer a reasonable escalation pathway from minimally invasive to surgical approaches. At Beth Israel Deaconess Medical Center, the Chest Disease Center integrates IP and TS within a unified divisional structure supported by joint clinics, shared referral pathways, and routine multidisciplinary conferences involving radiology, oncology, and other specialties as needed. In this descriptive review, we present an institutional blueprint for integrated care using four representative disease domains: expiratory central airway collapse (ECAC), emphysema requiring lung volume reduction (LVR) strategies, early-stage lung cancer and peripheral pulmonary nodules (PPNs), and pleural disease including complicated pleural infection (CPI) and persistent air leak (PAL). Amongst those clinical entities, early dual-specialty evaluation enables timely diagnosis, individualized treatment planning, and streamlined transitions between bronchoscopic and operative options. Additionally, this framework also facilitates clinical research integration, including prospective trials embedded within routine workflows. We propose that a unified IP-TS MDT model enhances coordination, preserves continuity, and improves the efficiency of complex pulmonary care delivery, offering a practical template for adoption by other institutions seeking to align procedural innovation with patient-centered outcomes.

Medical thoracoscopy (MT) is a minimally invasive procedure with a well-established role in the diagnosis and management of malignant pleural disease; however, its therapeutic applications in benign pleural conditions remain variably adopted and inconsistently defined. In response to increasing clinical utilisation and emerging evidence, the World Association for Bronchology and Interventional Pulmonology (WABIP) and the American Association for Bronchology and Interventional Pulmonology (AABIP) convened a multidisciplinary, international expert panel to develop a consensus statement examining the therapeutic role of MT in benign pleural disease. Six clinically relevant PICO (patient, intervention, comparison and outcome) questions were formulated to guide a systematic literature review of PubMed, Scopus and Cochrane databases from 1980 through 2025. Evidence was appraised using standardised risk-of-bias tools and consensus was achieved using a modified Delphi methodology. This consensus statement summarises the available evidence regarding MT across a spectrum of benign pleural conditions, including recurrent benign pleural effusions, primary and secondary spontaneous pneumothorax, empyema, and tuberculous pleural disease. Emphasis is placed on procedural outcomes, complication profiles and comparative effectiveness relative to alternative medical and surgical approaches. The document also highlights key considerations related to patient selection, procedural complexity and the influence of operator expertise and local resources on clinical outcomes. Given the heterogeneity of underlying disease processes and the predominance of observational data, this work is presented as a consensus statement rather than a formal clinical practice guideline. Overall, it aims to consolidate current knowledge, identify gaps in evidence and provide a practical framework to inform multidisciplinary decision-making and future research on the therapeutic use of MT in benign pleural disease.

INTRODUCTION:Mesh erosion is an increasingly recognized delayed complication of tracheobronchoplasty (TBP) for severe tracheobronchomalacia (TBM). While historically reported in fewer than 0.5% of cases, recent case series with extended follow-up have identified isolated events, including one erosion among 12 patients (8.3%). This case series illustrates the endoscopic management of mesh erosion in four patients, emphasizing bronchoscopic resection as a viable alternative to surgical removal in select cases. CASE PRESENTATION:Four patients (ages 49-78) with severe TBM underwent TBP using posterior tracheobronchial mesh. All developed delayed-onset respiratory symptoms including progressive dyspnea, chronic cough, and recurrent infections. Comorbidities included severe COPD, diabetes, GERD, and immunosuppressive conditions. Computed tomography imaging raised concern for airway compromise; diagnostic bronchoscopy confirmed mesh erosion into the airway lumen in all cases, with tracheal and bronchial involvement and varying degrees of obstruction. Therapeutic bronchoscopy was performed using a combined rigid and flexible approach. Mesh segments eroding into the airway were selectively resected using biopsy forceps and laparoscopic scissors under direct visualization. Procedures were well-tolerated, with no intraoperative complications. In two patients, airway patency improved to >90% post-intervention. The remaining patients underwent partial mesh trimming, achieving symptomatic and infectious control. Adjunctive therapies included culture-guided antibiotics, mucociliary clearance optimization, and GERD management. One patient underwent hyperbaric oxygen therapy for mucosal healing. All patients remained clinically stable on follow-up, with improved symptom scores and no need for repeat bronchoscopic resection to date. CONCLUSIONS:Bronchoscopic resection of eroded mesh following TBP is a safe, effective, and less invasive option that can relieve airway obstruction, reduce infection burden, improve symptoms and quality of life in carefully selected patients. Timely diagnosis through imaging and endoscopic assessment is essential, and management should be guided by a multidisciplinary approach.

We report the case of a 44-year-old woman with a typical carcinoid tumour of the left mainstem bronchus managed through a multidisciplinary and combined approach. Initial symptoms included haemoptysis and progressive wheezing. A subsequent bronchoscopy revealed a highly vascular, pedunculated mass nearly occluding the airway. En bloc resection using electrocautery and a cryoprobe enabled airway recanalization and diagnosis. Endobronchial ultrasound-guided transbronchial fine needle aspiration ruled out nodal disease. Histopathological examination confirmed a typical carcinoid tumour.  Robotic-assisted sleeve resection was subsequently performed, preserving parenchyma and achieving negative margins. Surveillance bronchoscopy showed a well-healed anastomosis with no granulation. This case highlights the importance of bronchoscopic interventions in staging and treatment planning, as well as their role in facilitating lung-sparing surgical strategies.

Shape-sensing robotic-assisted bronchoscopy (ssRAB) represents a major advancement in the bronchoscopic evaluation of pulmonary nodules suspicious for malignancy. Its use has expanded across multiple countries and healthcare systems; however, no global consensus currently exists to guide clinical practice or address areas of uncertainty. This first world expert consensus was developed by an international panel of 18 specialists in interventional pulmonology and ssRAB, representing 13 hospitals across three continents. The process included a systematic literature review, followed by multiple rounds of structured questionnaires, sharing of clinical experience, and informed discussion, in order to identify key domains and establish consensus statements. A total of 38 recommendations were generated across domains including indications and contraindications, procedural set up, practical workflow, anesthesia considerations, diagnostic tools, training, reporting standards, and safety practices of ssRAB. Full consensus (100% agreement) was achieved for all 38 statements following three voting rounds and extensive discussion. This first international expert consensus provides comprehensive, evidence-informed guidance on the clinical use of ssRAB. It also highlights areas of ongoing uncertainty and can serve as a foundation for future research, education, and guideline development in this rapidly evolving field.

Refractory pleural effusions in patients unable to safely manage external drainage systems pose a challenge for conventional management strategies. In this report, we describe the placement of a fully implantable shunt to provide continuous pleuroperitoneal drainage in a patient with severe neuropsychiatric comorbidity. Medical thoracoscopy enabled pleural biopsy and shunt implantation in a single procedural episode with direct visualization for catheter positioning and assessment of pleural anatomy. This internalized approach may offer a durable, discreet alternative when indwelling catheters or pleurodesis are impractical.

Background:Recent growth of navigational bronchoscopy has included use of new platforms and tools, the benefit of which remains under study. Research Question:Does diagnostic yield differ between: (a) electromagnetic navigation bronchoscopy versus shape-sensing robotic-assisted bronchoscopy; (b) ssRAB versus ssRAB with cone-beam CT (ssRAB-CBCT); and (c) nodule sampling with versus without cryobiopsy? Methods:This single-center retrospective study evaluated the diagnostic performance of navigational bronchoscopy cases with acquisition of new platforms and tools at a bronchoscopy referral center between 2016 and March 2024. Diagnostic yield was evaluated for the primary procedural target, with yield defined as per ATS/ACCP guidelines. Results:A total of 185 ENB cases, 371 ssRAB cases, and 54 ssRAB-CBCT cases were available for comparison. Diagnostic yield was 57% for ENB, 72% for ssRAB and 78% for ssRAB-CBCT (ENB vs. ssRAB P=0.001; ssRAB vs. ssRAB-CBCT P=0.307). Diagnostic yield was 78% for ssRAB/ssRAB-CBCT procedures that used cryobiopsy versus 69% for procedures that did not (P=0.035). Nodule size differed between procedure types: median size 27 mm (IQR 17 to 35 mm) for ENB, 21 mm (IQR 16 to 30 mm) for ssRAB (P=0.001 for ENB vs. ssRAB), and 17 mm (IQR 13 to 25) for ssRAB-CBCT (P=0.004 for ssRAB vs. ssRAB-CBCT). Differences were found between ENB and ssRAB procedures regarding nodule location in the peripheral third of lung (ENB 50% vs. ssRAB 62%, P=0.009) and presence of a bronchus sign (ENB 81% vs. ssRAB 43%, P=<0.001), whereas other nodule characteristics were similar between groups. Conclusion:Acquisition of new tools for navigational bronchoscopy was associated with increased diagnostic yield despite performing biopsies on increasingly difficult cases.

Background: Open window thoracostomy (OTW) is the standard of care for debilitated patients with chronic pleural infection and nonexpandable lungs (NEL) who are not candidates for major surgical intervention. Tunneled pleural catheters (TPC) offer tremendous treatment potential in this setting based on their efficacy in malignant pleural effusion and NEL. We aim to assess the efficacy, safety, and health care utilization of TPC in this setting. Methods: We retrospectively evaluated patients who underwent TPC procedures for the long-term management of chronic pleural infection and NEL who were not candidates for major surgical intervention. Clinically, complete treatment success was defined as fever abatement, normalization of white cell count, and stoppage of antimicrobial therapy without requiring surgical intervention. It is deemed a partial success if chronic antimicrobial suppression is still needed. Results: There were 20 patients who had TPC placed for chronic pleural infection with NEL. Clinical and partial treatment success was achieved in 9/17 and 8/17 patients, respectively, excluding 3 patients who were placed on comfort measures only. The median change in pleural volume was -218 mL. The median length of stay after TPC placement was 4.5 days. TPC was removed in 8 patients due to successful obliteration of pleural space in a median duration of 46.5 days. Four patients passed away with TPCs in place, 7 retained TPCs at the last health care system contact, and 1 patient had OTW due to TPC failure. Conclusion: This exploratory study suggests that TPC is an effective and safe intervention for the management of patients with chronic pleural infection and NEL lung who are not candidates for surgical intervention.