Efficacy and safety of bronchoscopic cryotherapy for granular endobronchial tuberculosis

Abstract

Background: The most important sequela of endobronchial tuberculosis (EBTB) is bronchial stenosis, which causes wheezing, dyspnea and obstructive pneumonia. But there have been no reports about applying cryotherapy for granular EBTB that did not show luminal narrowing of the bronchus at diagnosis. Whether this technique is useful for preventing granular EBTB from progressing into stenosis needs to be clarified.

Objective: To investigate the efficacy and safety of bronchoscopic cryotherapy for granular endobronchial tuberculosis.

Methods: In this study, we analyzed the records of 76 patients with granular EBTB. Diagnosis of TB was confirmed by microbiology or histopathology. Bronchoscopic examinations revealed that the patients had granular endobronchial tuberculosis. Thirty-eight patients received bronchoscopic cryotherapy plus routine anti-tuberculosis chemotherapy and the other 38 patients received routine anti-tuberculosis chemotherapy alone. We compared the treatment effect of these 2 groups. The outcome measures were the changes of lesions, the rate of disappearance of lesions and complications of bronchoscopic cryotherapy.

Results: The complete removal rate was 100% in patients with bronchoscopic cryotherapy plus routine anti-tuberculosis chemotherapy; the complete removal rate was 78.9% in patients with anti-tuberculosis chemotherapy alone; the rate of disappearance of lesions in the bronchoscopic cryotherapy plus routine anti-tuberculosis chemotherapy group was faster than that of the anti-tuberculosis chemotherapy alone group. There were no severe complications from bronchoscopic cryotherapy.

Conclusions: Bronchoscopic cryotherapy can accelerate the healing of granular EBTB and help to prevent progressive bronchial stenosis due to granular EBTB and is a very safe method.