Surgical repair for post-tuberculosis tracheobronchial stenosis

Asian Cardiovasc Thorac Ann. 2021 Jan;29(1):26-32. doi: 10.1177/0218492320963972. Epub 2020 Sep 30.

Abstract

Aim: Post-tuberculosis tracheobronchial stenosis is rare but one of the most dangerous complications of tracheobronchial tuberculosis. Balloon dilatation, stent insertion, laser photoresection, argon plasma coagulation, and cryotherapy are some of the initial treatments recommended for mild to moderate cases. Here, we report a case series of patients who underwent segmental resection and end-to-end anastomosis for bronchial stenosis and a sliding technique for severe and long-segment tracheal stenosis.

Methods: We retrospectively reviewed the medical records of patients with post-tuberculosis tracheobronchial stenosis operated on in our thoracic surgery department. Of the 7 cases that were treated, two had severe tracheal stenosis stretching over 50% of the tracheal length, one was operated on using resection and end-to-end anastomosis, and the other had sliding tracheoplasty. The other 5 cases of bronchial stem stenosis were treated with segmental resection and end-to-end anastomosis.

Results: All five patients with bronchial stenosis had a good outcome; the ipsilateral lung was well ventilated and respiratory function was good. One patient with tracheal stenosis, treated with segmental resection and end-to-end anastomosis, died after the surgery, and the other patient, treated with slide tracheoplasty, had a good recovery.

Conclusion: The treatment plan for patients with post-tuberculosis tracheobronchial stenosis should be on a patient-by-patient basis. Sliding tracheoplasty can be a treatment option in patients with long-segment tracheal stenosis.

Keywords: Bronchial diseases; constriction; pathologic; pulmonary; tracheal stenosis; tuberculosis.

MeSH terms

  • Adult
  • Airway Obstruction / diagnostic imaging
  • Airway Obstruction / etiology
  • Airway Obstruction / surgery*
  • Anastomosis, Surgical
  • Bronchial Diseases / diagnostic imaging
  • Bronchial Diseases / etiology
  • Bronchial Diseases / surgery*
  • Female
  • Humans
  • Retrospective Studies
  • Severity of Illness Index
  • Thoracic Surgical Procedures* / adverse effects
  • Tracheal Stenosis / diagnostic imaging
  • Tracheal Stenosis / etiology
  • Tracheal Stenosis / surgery*
  • Treatment Outcome
  • Tuberculosis, Pulmonary / complications*
  • Young Adult