{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T10:50:13Z","timestamp":1791888613895,"version":"4.3.4"},"reference-count":142,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T00:00:00Z","timestamp":1790899200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T00:00:00Z","timestamp":1790899200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Clin. Med.","JCM"],"abstract":"<jats:p>Background: Malignant tracheal stenosis (MTS) is a rare, life-threatening condition caused by primary tracheal tumor, mainly adenoid cystic carcinoma (ACC) and squamous cell carcinoma (SCC), and more rarely other primary neoplasms such as lymphomas, or local extension\/metastasis from adjacent malignancies (thyroid, esophageal, lung, or mediastinal cancers). Accounting for &lt;0.1% of respiratory tumors, MTS presents with progressive respiratory failure, requiring urgent multidisciplinary care involving thoracic surgery, interventional pulmonology, oncology, and intensive care. Diagnosis relies on clinical evaluation, advanced imaging and endoscopy. Bronchoscopy (BC) remains the best investigation for direct visualization and biopsy or performing therapeutic maneuvers. Prognosis depends on histology, local extent, and achieving R0 resection. Tracheal resection with primary anastomosis remains the curative standard for resectable cases. Interventional procedures (debulking, laser, cryotherapy, stenting) are essential for palliative management and acute stabilization. Methods: A structured (non-systematic) search of PubMed\/MEDLINE, Embase, Scopus, and Web of Science (1965\u20132025) was performed using MeSH\/Emtree terms and free-text keywords. Studies were included if they evaluated adult patients with malignant central airway stenosis, primary tracheal tumors, or secondary invasion undergoing surgical, bronchoscopic, or multimodal interventions, including ECMO support. Results: Malignant tracheal stenosis (MTS)\u2014predominantly adenoid cystic and squamous cell carcinomas\u2014imposes a critical clinical burden despite its low incidence. Complete surgical resection with negative margins remains the curative treatment for resectable disease. In unresectable cases, multimodal palliative interventions (stenting, laser\/electrocautery ablation, and mechanical debulking) provide rapid airway restoration and quality-of-life improvements, whereas ECMO is an established rescue or adjunctive support strategy in selected critical airway procedures performed in experienced centers. Three-dimensional bioprinting and tissue-engineered reconstruction remain experimental or early clinical, and bioresorbable stents and artificial intelligence (AI)-based tools remain investigational; none is currently part of routine MTS management. Conclusions: R0 resection for appropriately selected resectable disease and interventional airway management for unresectable symptomatic disease are the best-supported strategies, although the evidence derives mainly from retrospective series from specialized centers. Emerging technologies require prospective validation before clinical adoption. Management should be individualized, multidisciplinary and centralized in experienced airway centers.<\/jats:p>","DOI":"10.3390\/jcm15197638","type":"journal-article","created":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T09:10:48Z","timestamp":1790932248000},"page":"7638","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Malignant Tracheal Stenosis: A Narrative Review of Current Diagnostic and Therapeutic Approaches"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6419-7805","authenticated-orcid":false,"given":"Cornel Florentin","family":"Savu","sequence":"first","affiliation":[{"name":"Department of Thoracic Surgery, \u201cMarius Nasta\u201d National Institute of Pneumology, 050150 Bucharest, Romania"},{"name":"Thoracic Surgery I, University of Medicine and Pharmacy \u201cCarol Davila\u201d, 020021 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amir-Andrei","family":"Sabha","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, \u201cMarius Nasta\u201d National Institute of Pneumology, 050150 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-5095-6279","authenticated-orcid":false,"given":"Mihaela-Beatrice","family":"Tivadar","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, \u201cMarius Nasta\u201d National Institute of Pneumology, 050150 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-3856-7917","authenticated-orcid":false,"given":"Silviu Gabriel","family":"Vlasceanu","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, \u201cMarius Nasta\u201d National Institute of Pneumology, 050150 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mihnea","family":"Orghidan","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, \u201cMarius Nasta\u201d National Institute of Pneumology, 050150 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-3426-0671","authenticated-orcid":false,"given":"Andrei-Cristian","family":"Bobocea","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, \u201cMarius Nasta\u201d National Institute of Pneumology, 050150 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,10,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"426","DOI":"10.1016\/j.chest.2016.02.001","article-title":"Central airway obstruction: Benign strictures, tracheobronchomalacia, and malignancy-related obstruction","volume":"150","author":"Murgu","year":"2016","journal-title":"Chest"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1278","DOI":"10.1164\/rccm.200210-1181SO","article-title":"Central airway obstruction","volume":"169","author":"Ernst","year":"2004","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_3","unstructured":"Grillo, H.C. (2004). Surgery of the Trachea and Bronchi, PMPH USA."},{"key":"ref_4","first-page":"S160","article-title":"Complications after tracheal resection and reconstruction: Prevention and treatment","volume":"8","author":"Auchincloss","year":"2016","journal-title":"J. Thorac. Dis."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"763","DOI":"10.3109\/00016480903403005","article-title":"Clinical aspects and treatment of primary tracheal malignancies","volume":"130","author":"Honings","year":"2010","journal-title":"Acta Oto-Laryngol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"244","DOI":"10.21037\/acs.2018.03.04","article-title":"Overview of malignant tracheal tumors","volume":"7","author":"Madariaga","year":"2018","journal-title":"Ann. Cardiothorac. Surg."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1016\/S1052-3359(03)00019-X","article-title":"Primary tracheal tumors","volume":"13","author":"Gaissert","year":"2003","journal-title":"Chest Surg. Clin."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"3781","DOI":"10.21037\/jtd.2016.12.67","article-title":"Tracheal and bronchial tumors","volume":"8","author":"Varela","year":"2016","journal-title":"J. Thorac. Dis."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1016\/j.ccm.2007.11.002","article-title":"Imaging of the large airways","volume":"29","author":"Boiselle","year":"2008","journal-title":"Clin. Chest Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1111\/1759-7714.14315","article-title":"Reconstruction of the trachea and carina: Surgical reconstruction, autologous tissue transplantation, allograft transplantation, and bioengineering","volume":"13","author":"Ren","year":"2022","journal-title":"Thorac. Cancer"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1093\/ejcts\/ezu162","article-title":"Extracorporeal membrane oxygenation support for complex tracheo-bronchial procedures","volume":"47","author":"Lang","year":"2015","journal-title":"Eur. J. Cardio-Thorac. Surg."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"4039","DOI":"10.21037\/tlcr-21-731","article-title":"Carinal resection and reconstruction: Now and in the future","volume":"10","author":"Matsuura","year":"2021","journal-title":"Transl. Lung Cancer Res."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"E1168","DOI":"10.21037\/jtd.2016.10.101","article-title":"Central airway tumors: Interventional bronchoscopy in diagnosis and management","volume":"8","author":"Lin","year":"2016","journal-title":"J. Thorac. Dis."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1651","DOI":"10.1378\/chest.121.5.1651","article-title":"Recent advances in central airway imaging","volume":"121","author":"Boiselle","year":"2002","journal-title":"Chest"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1148\/rg.291085126","article-title":"Tumors in the tracheobronchial tree: CT and FDG PET features","volume":"29","author":"Park","year":"2009","journal-title":"Radiographics"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1889","DOI":"10.1016\/j.athoracsur.2004.05.064","article-title":"Long-term survival after resection of primary adenoid cystic and squamous cell carcinoma of the trachea and carina","volume":"78","author":"Gaissert","year":"2004","journal-title":"Ann. Thorac. Surg."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"808","DOI":"10.1016\/S0022-5223(96)70341-0","article-title":"Results and prognostic factors in resections of primary tracheal tumors: A multicenter retrospective study","volume":"111","author":"Fourquier","year":"1996","journal-title":"J. Thorac. Cardiovasc. Surg."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"697","DOI":"10.1016\/0002-9610(82)90039-3","article-title":"Management of tracheal tumors","volume":"143","author":"Grillo","year":"1982","journal-title":"Am. J. Surg."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1016\/S0022-5223(99)70468-X","article-title":"Clinical experience with carinal resection","volume":"117","author":"Mitchell","year":"1999","journal-title":"J. Thorac. Cardiovasc. Surg."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Bolliger, C.T., and Mathur, P.N. (1999). Interventional Bronchoscopy, Karger Medical and Scientific Publishers.","DOI":"10.1159\/isbn.978-3-318-00415-1"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1653","DOI":"10.1378\/chest.104.6.1653","article-title":"Silicone stents in the management of inoperable tracheobronchial stenoses: Indications and limitations","volume":"104","author":"Bolliger","year":"1993","journal-title":"Chest"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1282","DOI":"10.1378\/chest.14-1526","article-title":"Therapeutic bronchoscopy for malignant central airway obstruction","volume":"147","author":"Ost","year":"2015","journal-title":"Chest"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1378\/chest.97.2.328","article-title":"A dedicated tracheobronchial stent","volume":"97","author":"Dumon","year":"1990","journal-title":"Chest"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"273","DOI":"10.21037\/acs.2018.03.08","article-title":"Airway stents","volume":"7","author":"Folch","year":"2018","journal-title":"Ann. Cardiothorac. Surg."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"360","DOI":"10.21037\/atm-22-2878","article-title":"Patient-specific airway stent using three-dimensional printing: A review","volume":"11","author":"Aravena","year":"2022","journal-title":"Ann. Transl. Med."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"e357","DOI":"10.1016\/j.athoracsur.2016.09.082","article-title":"Stenting of complex malignant central-airway obstruction guided by a three-dimensional printed model of the airways","volume":"103","author":"Guibert","year":"2017","journal-title":"Ann. Thorac. Surg."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"e10671","DOI":"10.1002\/btm2.10671","article-title":"Tissue-engineered tracheal implants: Advancements, challenges, and clinical considerations","volume":"9","author":"Wei","year":"2024","journal-title":"Bioeng. Transl. Med."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"3833","DOI":"10.21037\/tcr-2025-318","article-title":"Diagnosis and multimodality treatment of primary malignant tracheal tumors","volume":"14","author":"Bibas","year":"2025","journal-title":"Transl. Cancer Res."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"26","DOI":"10.21037\/shc.2019.11.09","article-title":"Management of malignant central airway obstruction","volume":"4","author":"Pasricha","year":"2020","journal-title":"Shanghai Chest"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1016\/j.chest.2024.06.3804","article-title":"Management of central airway obstruction: An American College of Chest Physicians clinical practice guideline","volume":"167","author":"Mahmood","year":"2025","journal-title":"Chest"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"968","DOI":"10.1245\/s10434-006-9229-z","article-title":"Incidence and treatment of tracheal cancer: A nationwide study in the Netherlands","volume":"14","author":"Honings","year":"2007","journal-title":"Ann. Surg. Oncol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1522","DOI":"10.1016\/S0022-5223(96)70011-9","article-title":"Adenoid cystic carcinoma of the airway: Thirty-two-year experience","volume":"112","author":"Maziak","year":"1996","journal-title":"J. Thorac. Cardiovasc. Surg."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1002\/lary.24123","article-title":"Management and prognosis of primary tracheal cancer: A national analysis","volume":"124","author":"Nouraei","year":"2014","journal-title":"Laryngoscope"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"e36787","DOI":"10.1097\/MD.0000000000036787","article-title":"Prognostic factors and constructing a nomogram in tracheal cancer patients treated with surgical intervention: A study based on SEER database","volume":"103","author":"Shi","year":"2024","journal-title":"Medicine"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"894","DOI":"10.1002\/1097-0142(19900901)66:5<894::AID-CNCR2820660514>3.0.CO;2-W","article-title":"Primary malignant tumors of the trachea. A radiologic and clinical study","volume":"66","author":"Li","year":"1990","journal-title":"Cancer"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1016\/j.athoracsur.2006.01.065","article-title":"Uncommon primary tracheal tumors","volume":"82","author":"Gaissert","year":"2006","journal-title":"Ann. Thorac. Surg."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"286","DOI":"10.1177\/107327480601300406","article-title":"Tracheobronchial gland tumors","volume":"13","author":"Gaissert","year":"2006","journal-title":"Cancer Control"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"e230045","DOI":"10.1148\/rg.230045","article-title":"Malignant and benign tracheobronchial neoplasms: Comprehensive review with radiologic, bronchoscopic, and pathologic correlation","volume":"43","author":"Girvin","year":"2023","journal-title":"Radiographics"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1016\/j.thorsurg.2013.09.008","article-title":"Pathology of tracheal tumors","volume":"24","author":"Junker","year":"2014","journal-title":"Thorac. Surg. Clin."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"3401","DOI":"10.21037\/jtd.2016.11.24","article-title":"Tracheobronchial tumors","volume":"8","author":"Stevic","year":"2016","journal-title":"J. Thorac. Dis."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"115","DOI":"10.21037\/amj.2018.11.06","article-title":"Management of malignant airway obstruction","volume":"3","author":"Oberg","year":"2018","journal-title":"AME Med. J."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1016\/j.jamcollsurg.2005.09.016","article-title":"Primary tracheal malignant neoplasms: The University of Texas MD Anderson Cancer Center experience","volume":"202","author":"Webb","year":"2006","journal-title":"J. Am. Coll. Surg."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"767","DOI":"10.2147\/CMAR.S501202","article-title":"Treatment and outcomes of primary tracheal adenoid cystic carcinoma: A systematic review","volume":"17","author":"Shi","year":"2025","journal-title":"Cancer Manag. Res."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"183","DOI":"10.21037\/acs.2018.02.01","article-title":"Secondary tracheal tumors: A systematic review","volume":"7","author":"Madariaga","year":"2018","journal-title":"Ann. Cardiothorac. Surg."},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Jain, P., and Mehta, A.C. (2016). Diseases of central airways: An overview. Diseases of the Central Airways: A Clinical Guide, Humana Press.","DOI":"10.1007\/978-3-319-29830-6_1"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"682","DOI":"10.1136\/pgmj.2009.089011","article-title":"Endobronchial stenting in the management of large airway pathology","volume":"85","author":"Ranu","year":"2009","journal-title":"Postgrad. Med. J."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1159\/000339408","article-title":"Surgical management of malignant tumors of the trachea: Report of two cases and review of literature","volume":"5","author":"Yasumatsu","year":"2012","journal-title":"Case Rep. Oncol."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"e70893","DOI":"10.1002\/cam4.70893","article-title":"Diagnosis and treatment of primary tracheobronchial tumors","volume":"14","author":"Shu","year":"2025","journal-title":"Cancer Med."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"96","DOI":"10.17116\/hirurgia202005196","article-title":"Circular resection of the thoracic trachea for MALT lymphoma in an 81-year-old female patient","volume":"5","author":"Topolnitskiy","year":"2020","journal-title":"Khirurgiya. Zhurnal im. N.I. Pirogova"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1438","DOI":"10.1016\/j.ejcts.2010.01.005","article-title":"Prognostic value of pathologic characteristics and resection margins in tracheal adenoid cystic carcinoma","volume":"37","author":"Honings","year":"2010","journal-title":"Eur. J. Cardio-Thorac. Surg."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"S75","DOI":"10.1016\/j.ijsu.2015.12.036","article-title":"Thyroid cancer invading the airway: Diagnosis and management","volume":"28","author":"Avenia","year":"2016","journal-title":"Int. J. Surg."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"175","DOI":"10.5152\/TurkThoracJ.2021.19132","article-title":"Esophageal cancer, central airway obstruction, and lots more: A collaborative approach to a challenging scenario","volume":"22","author":"Niwas","year":"2021","journal-title":"Turk. Thorac. J."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1016\/j.suronc.2004.01.001","article-title":"Airway stenting for unresectable esophageal cancer","volume":"13","author":"Sihoe","year":"2004","journal-title":"Surg. Oncol."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"S1087","DOI":"10.21037\/jtd.2017.07.27","article-title":"Malignant central airway obstruction","volume":"9","author":"Mudambi","year":"2017","journal-title":"J. Thorac. Dis."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"773","DOI":"10.3892\/etm.2021.10205","article-title":"Tumoral markers in bladder cancer","volume":"22","author":"Bratu","year":"2021","journal-title":"Exp. Ther. Med."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1183\/09031936.00132804","article-title":"A proposed classification system of central airway stenosis","volume":"30","author":"Freitag","year":"2007","journal-title":"Eur. Respir. J."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"639","DOI":"10.1016\/j.otohns.2004.05.018","article-title":"Contemporary staging and prognosis for primary tracheal malignancies: A population-based analysis","volume":"131","author":"Bhattacharyya","year":"2004","journal-title":"Otolaryngol. Neck Surg."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1288\/00005537-199203000-00002","article-title":"Surgical considerations in tracheal stenosis","volume":"102","author":"Anand","year":"1992","journal-title":"Laryngoscope"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"731","DOI":"10.1016\/j.jtcvs.2004.07.005","article-title":"Anastomotic complications after tracheal resection: Prognostic factors and management","volume":"128","author":"Wright","year":"2004","journal-title":"J. Thorac. Cardiovasc. Surg."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"682","DOI":"10.1002\/lary.20800","article-title":"The management of thyroid carcinoma invading the larynx or trachea","volume":"120","author":"Honings","year":"2010","journal-title":"Laryngoscope"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"1155","DOI":"10.1016\/j.otc.2008.08.002","article-title":"Invasive thyroid cancer: Management of the trachea and esophagus","volume":"41","author":"Price","year":"2008","journal-title":"Otolaryngol. Clin. N. Am."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"e01369","DOI":"10.1002\/rcr2.1369","article-title":"A case of endobronchial mucosa-associated lymphoid tissue (MALT) lymphoma successfully treated with radiotherapy and a review of the literature","volume":"12","author":"Arai","year":"2024","journal-title":"Respirol. Case Rep."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1177\/000348949410300410","article-title":"Proposed grading system for subglottic stenosis based on endotracheal tube sizes","volume":"103","author":"Myer","year":"1994","journal-title":"Ann. Otol. Rhinol. Laryngol."},{"key":"ref_64","doi-asserted-by":"crossref","unstructured":"Mammana, M., Bonis, A., Verzeletti, V., Dell\u2019Amore, A., and Rea, F. (2024). Tracheal tissue engineering: Principles and state of the art. Bioengineering, 11.","DOI":"10.3390\/bioengineering11020198"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"1451247","DOI":"10.3389\/or.2024.1451247","article-title":"Tracheal tumors: Clinical practice guidelines for palliative treatment and follow-up","volume":"18","author":"Winiarczyk","year":"2024","journal-title":"Oncol. Rev."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1159\/000329703","article-title":"Advanced malignant lung disease: What the specialist can offer","volume":"82","author":"Gompelmann","year":"2011","journal-title":"Respiration"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"3277","DOI":"10.21037\/jtd.2018.06.01","article-title":"Clinical assessment of airway stent placement in patients with malignant airway lesions","volume":"10","author":"Huang","year":"2018","journal-title":"J. Thorac. Dis."},{"key":"ref_68","first-page":"84","article-title":"Pulmonary function tests","volume":"80","author":"Ranu","year":"2011","journal-title":"Ulst. Med. J."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"323","DOI":"10.4329\/wjr.v2.i8.323","article-title":"Interventional management of tracheobronchial strictures","volume":"2","author":"Shin","year":"2010","journal-title":"World J. Radiol."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"442","DOI":"10.1159\/000479164","article-title":"Towards individualized tracheobronchial stents: Technical, practical and legal considerations","volume":"94","author":"Freitag","year":"2017","journal-title":"Respiration"},{"key":"ref_71","unstructured":"Naidich, D. (1999). Computed Tomography and Magnetic Resonance of the Thorax, Lippincott-Raven."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"1389","DOI":"10.1016\/j.ejca.2008.11.043","article-title":"Endobronchial ultrasound-guided transbronchial needle aspiration for staging of lung cancer: A systematic review and meta-analysis","volume":"45","author":"Gu","year":"2009","journal-title":"Eur. J. Cancer"},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"190178","DOI":"10.1183\/16000617.0178-2019","article-title":"Therapeutic bronchoscopy for central airway diseases","volume":"29","author":"Rosell","year":"2020","journal-title":"Eur. Respir. Rev."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"786","DOI":"10.1513\/AnnalsATS.201901-044CME","article-title":"Recent advances in interventional pulmonology","volume":"16","author":"Shafiq","year":"2019","journal-title":"Ann. Am. Thorac. Soc."},{"key":"ref_75","doi-asserted-by":"crossref","unstructured":"Mishra, M., Sindhwani, G., Rathore, S.S., Rajpoot, A., and Kumar, A. (2026). Clinical outcomes of rigid bronchoscopic airway interventions: Insights from an Indian tertiary care center. Monaldi Arch. Chest Dis.","DOI":"10.4081\/monaldi.2026.3686"},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1016\/S0022-5223(00)70184-X","article-title":"Bronchoscopic management of central airway obstruction","volume":"119","author":"Stephens","year":"2000","journal-title":"J. Thorac. Cardiovasc. Surg."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1378\/chest.06-0975","article-title":"State of the art: Interventional pulmonology","volume":"131","author":"Wahidi","year":"2007","journal-title":"Chest"},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"477","DOI":"10.1016\/j.rmr.2013.09.018","article-title":"Treatment of malignant central airways obstruction by rigid bronchoscopy","volume":"32","author":"Huret","year":"2013","journal-title":"Rev. Des. Mal. Respir."},{"key":"ref_79","doi-asserted-by":"crossref","unstructured":"Suk, P., \u0160r\u00e1mek, V., and \u010cundrle, I. (2021). Extracorporeal membrane oxygenation use in thoracic surgery. Membranes, 11.","DOI":"10.3390\/membranes11060416"},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"389","DOI":"10.4103\/aca.ACA_155_20","article-title":"Extracorporeal life support as a lifesaving procedure in palliative surgery of stenosing upper tracheal tumor","volume":"24","author":"Sawadogo","year":"2021","journal-title":"Ann. Card. Anaesth."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"2108","DOI":"10.21037\/jtd.2017.06.17","article-title":"Extracorporeal support in airway surgery","volume":"9","author":"Hoetzenecker","year":"2017","journal-title":"J. Thorac. Dis."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"84","DOI":"10.21037\/shc.2018.10.03","article-title":"Carinal resection","volume":"2","author":"Petrov","year":"2018","journal-title":"Shanghai Chest"},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"910","DOI":"10.1183\/09031936.06.00124905","article-title":"Endobronchial ultrasound-guided transbronchial needle aspiration of lymph nodes in the radiologically normal mediastinum","volume":"28","author":"Herth","year":"2006","journal-title":"Eur. Respir. J."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1111\/his.15076","article-title":"Pulmonary squamous cell carcinoma and lymphoepithelial carcinoma\u2013morphology, molecular characteristics and differential diagnosis","volume":"84","author":"Berezowska","year":"2024","journal-title":"Histopathology"},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"176","DOI":"10.3892\/etm.2021.11099","article-title":"Lung neuroendocrine tumors: A systematic literature review","volume":"23","author":"Savu","year":"2022","journal-title":"Exp. Ther. Med."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"200","DOI":"10.3892\/etm.2020.9330","article-title":"Neuroendocrine syndrome in bronchial carcinoid tumors","volume":"20","author":"Savu","year":"2020","journal-title":"Exp. Ther. Med."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1016\/j.lungcan.2004.06.008","article-title":"Adjuvant chemotherapy for radically resected non-small cell lung cancer: A retrospective analysis of 311 consecutively treated patients","volume":"47","author":"Dediu","year":"2005","journal-title":"Lung Cancer"},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"49","DOI":"10.17116\/onkolog20241301149","article-title":"Sinus histiocytosis of non-Langerhans cell type with obstruction of the subglottic larynx and trachea (Rosai\u2013Dorfman disease)","volume":"13","author":"Topolnitskiy","year":"2024","journal-title":"Onkol. Zhurnal Im. P.A. Gertsena"},{"key":"ref_89","unstructured":"Shields, T.W. (2005). General Thoracic Surgery, Lippincott Williams & Wilkins."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"27","DOI":"10.21037\/ccts-20-95","article-title":"Tracheal and carinal resections in the treatment of non-small cell lung cancer: A trend to a minimally invasive approach","volume":"3","year":"2021","journal-title":"Curr. Chall. Thorac. Surg."},{"key":"ref_91","first-page":"94","article-title":"Multidisciplinary Treatment of Malignant Tracheal Stenosis\u2014Beijing Expert Consensus","volume":"41","author":"Hongwu","year":"2014","journal-title":"Cancer Res. Prev. Treat."},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"518","DOI":"10.1111\/coa.14163","article-title":"Management of complex adult airway pathology through a multidisciplinary approach: An 8-year case series","volume":"49","author":"Nguyen","year":"2024","journal-title":"Clin. Otolaryngol."},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"9039","DOI":"10.21037\/jtd-2025-1445","article-title":"Real-world oncologic outcomes of thoracoscopic and open tracheal cancer resection","volume":"17","author":"Pohlman","year":"2025","journal-title":"J. Thorac. Dis."},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1016\/j.athoracsur.2016.01.080","article-title":"Video-assisted thoracic surgery resection and reconstruction of carina and trachea for malignant or benign disease in 12 patients: Three centers\u2019 experience in China","volume":"102","author":"Li","year":"2016","journal-title":"Ann. Thorac. Surg."},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"4932","DOI":"10.21037\/jtd.2017.11.88","article-title":"New era of \u201cresection of the carina and lower trachea\u201d","volume":"9","author":"Ujiie","year":"2017","journal-title":"J. Thorac. Dis."},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"798","DOI":"10.1177\/0003489414538764","article-title":"Complications after tracheal and cricotracheal resection and anastomosis for inflammatory and neoplastic stenoses","volume":"123","author":"Piazza","year":"2014","journal-title":"Ann. Otol. Rhinol. Laryngol."},{"key":"ref_97","first-page":"w20383","article-title":"Postoperative outcome of tracheal resection in benign and malignant tracheal stenosis","volume":"150","author":"Ferreirinha","year":"2020","journal-title":"Swiss Med. Wkly."},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"1251","DOI":"10.1002\/jso.27447","article-title":"Outcomes and predictors of survival for tracheal cancer","volume":"128","author":"Desai","year":"2023","journal-title":"J. Surg. Oncol."},{"key":"ref_99","doi-asserted-by":"crossref","unstructured":"Hsieh, C.-C., Sun, Y.-H., Lin, S.-W., Yeh, Y.-C., and Chan, M.-L. (2017). Surgical outcomes of pulmonary mucoepidermoid carcinoma: A review of 41 cases. PLoS ONE, 12.","DOI":"10.1371\/journal.pone.0176918"},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"1276","DOI":"10.4081\/cp.2020.1276","article-title":"Tracheal stenosis and recurrent nerve paralysis due to thyroid malignant lymphoma with huge chronic thyroiditis","volume":"10","author":"Kusunoki","year":"2020","journal-title":"Clin. Pract."},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"227","DOI":"10.21037\/acs.2018.03.07","article-title":"Functional outcome after (laryngo) tracheal resection and reconstruction for acquired benign (laryngo) tracheal stenosis","volume":"7","author":"Timman","year":"2018","journal-title":"Ann. Cardiothorac. Surg."},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1097\/LBR.0b013e318290b8de","article-title":"Rigid bronchoscopy and mechanical debulking in the management of central airway tumors: An Indian experience","volume":"20","author":"Vishwanath","year":"2013","journal-title":"J. Bronchol. Interv. Pulmonol."},{"key":"ref_103","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1097\/00128594-200204000-00004","article-title":"Curative bronchoscopic laser therapy for surgically resectable tracheobronchial tumors: Personal experience","volume":"9","author":"Cavaliere","year":"2002","journal-title":"J. Bronchol."},{"key":"ref_104","doi-asserted-by":"crossref","first-page":"781","DOI":"10.1378\/chest.119.3.781","article-title":"Endobronchial argon plasma coagulation for treatment of hemoptysis and neoplastic airway obstruction","volume":"119","author":"Morice","year":"2001","journal-title":"Chest"},{"key":"ref_105","doi-asserted-by":"crossref","first-page":"1427","DOI":"10.1016\/j.jtcvs.2003.12.032","article-title":"Cryorecanalization: A new approach for the immediate management of acute airway obstruction","volume":"127","author":"Hetzel","year":"2004","journal-title":"J. Thorac. Cardiovasc. Surg."},{"key":"ref_106","doi-asserted-by":"crossref","first-page":"856","DOI":"10.1513\/AnnalsATS.201508-486OC","article-title":"Unimodality and multimodality cryodebridement for airway obstruction. A single-center experience with safety and efficacy","volume":"13","author":"Inaty","year":"2016","journal-title":"Ann. Am. Thorac. Soc."},{"key":"ref_107","doi-asserted-by":"crossref","first-page":"484","DOI":"10.1159\/000497213","article-title":"Interventional bronchoscopy for the treatment of malignant central airway stenosis: An expert recommendation for China","volume":"97","author":"Jin","year":"2019","journal-title":"Respiration"},{"key":"ref_108","doi-asserted-by":"crossref","first-page":"7790","DOI":"10.21037\/jtd-2025-757","article-title":"Efficacy and survival of photodynamic treatment for tracheal adenoid cystic carcinoma: A two-center retrospective analysis","volume":"17","author":"Yang","year":"2025","journal-title":"J. Thorac. Dis."},{"key":"ref_109","first-page":"S124","article-title":"Tracheobronchial stenting of malignant and benign obstruction of large airways","volume":"124","author":"Papai","year":"2003","journal-title":"Chest"},{"key":"ref_110","doi-asserted-by":"crossref","first-page":"320","DOI":"10.1001\/archotol.1965.00760010322023","article-title":"T-tube tracheal stent","volume":"82","author":"Montgomery","year":"1965","journal-title":"Arch. Otolaryngol."},{"key":"ref_111","first-page":"164","article-title":"Airway stents: Present and future","volume":"1","author":"Colt","year":"1996","journal-title":"Lung Cancer"},{"key":"ref_112","doi-asserted-by":"crossref","first-page":"3600","DOI":"10.1038\/s41598-020-60566-6","article-title":"Clinical outcomes of self-expandable metallic stents for malignant obstructive atelectasis","volume":"10","author":"Bi","year":"2020","journal-title":"Sci. Rep."},{"key":"ref_113","doi-asserted-by":"crossref","first-page":"512","DOI":"10.1159\/000442054","article-title":"Biodegradable airway stents-bench to bedside: A comprehensive review","volume":"90","author":"Dutau","year":"2015","journal-title":"Respiration"},{"key":"ref_114","doi-asserted-by":"crossref","unstructured":"Stehlik, L., Guha, D., Anandakumar, S., Taskova, A., and Vasakova, M.K. (2024). Biodegradable tracheal stents: Our ten-year experience with adult patients. BMC Pulm. Med., 24.","DOI":"10.1186\/s12890-024-03057-y"},{"key":"ref_115","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1093\/icvts\/ivt466","article-title":"Recurrent oesophageal cancer complicated by tracheo-oesophageal fistula: Improved palliation by means of parallel tracheal and oesophageal stenting","volume":"18","author":"Schweigert","year":"2014","journal-title":"Interact. Cardiovasc. Thorac. Surg."},{"key":"ref_116","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1055\/s-2007-1013675","article-title":"Clinical evaluation of a new bifurcated dynamic airway stent: A 5-year experience with 135 patients","volume":"45","author":"Freitag","year":"1997","journal-title":"Thorac. Cardiovasc. Surg."},{"key":"ref_117","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1378\/chest.12-2282","article-title":"Biodegradable cisplatin-eluting tracheal stent for malignant airway obstruction: In vivo and in vitro studies","volume":"144","author":"Chao","year":"2013","journal-title":"Chest"},{"key":"ref_118","first-page":"619","article-title":"Novel biodegradable stents in the treatment of bronchial stenosis after lung transplantation","volume":"40","author":"Lischke","year":"2011","journal-title":"Eur. J. Cardio-Thorac. Surg."},{"key":"ref_119","doi-asserted-by":"crossref","first-page":"2043","DOI":"10.1056\/NEJMc1206319","article-title":"Bioresorbable airway splint created with a three-dimensional printer","volume":"368","author":"Zopf","year":"2013","journal-title":"N. Engl. J. Med."},{"key":"ref_120","doi-asserted-by":"crossref","first-page":"669","DOI":"10.1016\/j.jcrc.2013.05.020","article-title":"Use of venovenous extracorporeal membrane oxygenation in central airway obstruction to facilitate interventions leading to definitive airway security","volume":"28","author":"Hong","year":"2013","journal-title":"J. Crit. Care"},{"key":"ref_121","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1016\/S0169-5002(98)00018-X","article-title":"Radiation therapy alone in the treatment of tumours of the trachea","volume":"20","author":"Makarewicz","year":"1998","journal-title":"Lung Cancer"},{"key":"ref_122","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1016\/j.clon.2017.10.012","article-title":"Radiotherapy for tracheal\u2013bronchial cystic adenoid carcinomas","volume":"30","author":"Levy","year":"2018","journal-title":"Clin. Oncol."},{"key":"ref_123","doi-asserted-by":"crossref","first-page":"860","DOI":"10.1111\/resp.13292","article-title":"External beam radiation therapy combined with airway stenting leads to better survival in patients with malignant airway obstruction","volume":"23","author":"Mallow","year":"2018","journal-title":"Respirology"},{"key":"ref_124","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1097\/LBR.0000000000000879","article-title":"The prognostic predictors of airway stenting in malignant airway involvement from esophageal carcinoma","volume":"30","author":"Leelayuwatanakul","year":"2022","journal-title":"J. Bronchol. Interv. Pulmonol."},{"key":"ref_125","doi-asserted-by":"crossref","unstructured":"Wang, Q., Duan, Z., Liu, S., and Shi, R. (2024). Efficacy and risk factors of stent placement in the treatment of malignant tracheoesophageal fistula. Front. Oncol., 14.","DOI":"10.3389\/fonc.2024.1421020"},{"key":"ref_126","first-page":"S389","article-title":"The treatment strategy for tracheoesophageal fistula","volume":"7","author":"Ke","year":"2015","journal-title":"J. Thorac. Dis."},{"key":"ref_127","doi-asserted-by":"crossref","first-page":"1103","DOI":"10.1016\/j.ejcts.2008.06.025","article-title":"Esophagorespiratory fistulas of tumorous origin. Non-operative management of 264 cases in a 20-year period","volume":"34","author":"Balazs","year":"2008","journal-title":"Eur. J. Cardio-Thorac. Surg."},{"key":"ref_128","doi-asserted-by":"crossref","first-page":"1197","DOI":"10.1016\/S0003-4975(00)01614-3","article-title":"Malignant laryngotracheal obstruction: A way to treat serial stenoses of the upper airways","volume":"70","author":"Wassermann","year":"2000","journal-title":"Ann. Thorac. Surg."},{"key":"ref_129","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1177\/000348940111000411","article-title":"Concurrent glottic and tracheal stenoses: Restoration of airway continuity in end-stage malignant disease","volume":"110","author":"Wassermann","year":"2001","journal-title":"Ann. Otol. Rhinol. Laryngol."},{"key":"ref_130","doi-asserted-by":"crossref","first-page":"602","DOI":"10.1016\/j.anl.2016.03.009","article-title":"Treatment of large tracheal defects after resection: Laryngotracheal release and tracheal replacement","volume":"43","author":"Kirschbaum","year":"2016","journal-title":"Auris Nasus Larynx"},{"key":"ref_131","doi-asserted-by":"crossref","unstructured":"Bae, S.-W., Lee, K.-W., Park, J.-H., Lee, J., Jung, C.-R., Yu, J., Kim, H.-Y., and Kim, D.-H. (2018). 3D bioprinted artificial trachea with epithelial cells and chondrogenic-differentiated bone marrow-derived mesenchymal stem cells. Int. J. Mol. Sci., 19.","DOI":"10.3390\/ijms19061624"},{"key":"ref_132","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1186\/s42234-019-0031-1","article-title":"3D-bioprinted tracheal reconstruction: An overview","volume":"5","author":"Frejo","year":"2019","journal-title":"Bioelectron. Med."},{"key":"ref_133","doi-asserted-by":"crossref","first-page":"121246","DOI":"10.1016\/j.biomaterials.2021.121246","article-title":"3D bioprinting of a trachea-mimetic cellular construct of a clinically relevant size","volume":"279","author":"Park","year":"2021","journal-title":"Biomaterials"},{"key":"ref_134","doi-asserted-by":"crossref","first-page":"2961","DOI":"10.1111\/ajt.17137","article-title":"Airway replacement using stented aortic matrices: Long-term follow-up and results of the TRITON-01 study in 35 adult patients","volume":"22","author":"Martinod","year":"2022","journal-title":"Am. J. Transplant."},{"key":"ref_135","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1016\/j.media.2016.11.001","article-title":"Improving airway segmentation in computed tomography using leak detection with convolutional networks","volume":"36","author":"Charbonnier","year":"2017","journal-title":"Med. Image Anal."},{"key":"ref_136","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1186\/s12938-025-01408-2","article-title":"Emerging technologies in airway management: A narrative review of intubation robotics and anatomical structure recognition algorithms","volume":"24","author":"Chen","year":"2025","journal-title":"Biomed. Eng. OnLine"},{"key":"ref_137","doi-asserted-by":"crossref","first-page":"1477","DOI":"10.1517\/14712598.2014.938631","article-title":"Airway tissue engineering: An update","volume":"14","author":"Fishman","year":"2014","journal-title":"Expert Opin. Biol. Ther."},{"key":"ref_138","doi-asserted-by":"crossref","first-page":"210154","DOI":"10.1183\/16000617.0154-2021","article-title":"Development and clinical translation of tubular constructs for tracheal tissue engineering: A review","volume":"30","author":"Soriano","year":"2021","journal-title":"Eur. Respir. Rev."},{"key":"ref_139","unstructured":"Andrisani, D. (2023). L\u2019interazione tra Endoscopisti e Clinici: Significato Clinico e Risultati Della Valutazione Multimodale e Trattamento di Malattie Benigne e Maligne Delle vie Aeree. [Ph.D. Thesis, University of Modena and Reggio Emilia]."},{"key":"ref_140","doi-asserted-by":"crossref","unstructured":"Marghescu, A.-\u0218., Vl\u0103sceanu, S., Preda, M., \u021aig\u0103u, M., Dumitrache-Rujinski, \u0218., Leonte, D.G., M\u0103gheran, E.D., Tudor, A., B\u0103d\u0103r\u0103u, I.A., and Georgescu, L. (2024). Navigating the Maze: Exploring Non-Oncological Complexities in Non-Small-Cell Lung Cancer. Cancers, 16.","DOI":"10.3390\/cancers16101903"},{"key":"ref_141","doi-asserted-by":"crossref","unstructured":"Marghescu, A.-\u0218., Vl\u0103sceanu, S., Preda, M., Mahler, B., B\u0103d\u0103r\u0103u, I.A., Manolescu, L.S.C., \u021aig\u0103u, M., Teleag\u0103, C., Toader, C.E., and Radu, A.D. (2024). How Morphology Shapes Survival in Invasive Squamous Cell Carcinoma of the Lung. Diagnostics, 14.","DOI":"10.3390\/diagnostics14202264"},{"key":"ref_142","doi-asserted-by":"crossref","unstructured":"Vl\u0103sceanu, S., Mahler, B., Marghescu, A.\u0218., B\u0103d\u0103r\u0103u, I.A., Moldovan, H., Gheorghi\u021b\u0103, D., Costache, M., and Savu, C. (2024). The Nine-Year Survival of Patients Operated for Non-Small-Cell Lung Carcinoma in a Tertiary Centre: The Impact of the Tumour Stage and Other Patient-Related Parameters. Medicina, 60.","DOI":"10.3390\/medicina60030415"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/19\/7638\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T10:22:21Z","timestamp":1791886941000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/19\/7638"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,2]]},"references-count":142,"journal-issue":{"issue":"19","published-online":{"date-parts":[[2026,10]]}},"alternative-id":["jcm15197638"],"URL":"https:\/\/doi.org\/10.3390\/jcm15197638","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,2]]}}}