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Surgical management of airway obstruction in primary tuberculosis in children

K A Papagiannopoulos1, A G Linegar, D G Harris

  • 1Department of Cardiothoracic Surgery, University of Stellenbosch, Tygerberg Hospital, Cape Town, South Africa. kpapagiannopoulos@yahoo.com

The Annals of Thoracic Surgery
|October 30, 1999
PubMed

Insights

Surgical enucleation of mediastinal lymph nodes effectively treats airway obstruction in pediatric lymphobronchial tuberculosis. This safe procedure offers symptom relief and positive long-term outcomes for affected children.

Area of Science:

  • Pediatric Surgery
  • Pulmonology
  • Infectious Diseases

Background:

  • Lymphobronchial tuberculosis can cause severe airway obstruction in infants and young children.
  • Surgical intervention is considered for managing this critical condition when conservative measures fail.

Purpose of the Study:

  • To evaluate the safety and efficacy of surgical enucleation of mediastinal lymph nodes in pediatric patients with lymphobronchial tuberculosis causing airway obstruction.

Main Methods:

  • A retrospective review of nine pediatric patients (5-28 months old) who underwent surgery for lymphobronchial tuberculosis over a 4-year period.
  • All patients received posterolateral thoracotomies, with lymph node dissection and enucleation performed to relieve airway compression.
  • Six patients required preoperative mechanical ventilation due to respiratory failure.

Main Results:

  • All nine patients demonstrated significant clinical improvement post-surgery.
  • Patients were successfully weaned from mechanical ventilation within 24-72 hours postoperatively.
  • Seven patients with long-term follow-up remained symptom-free, indicating sustained positive outcomes.

Conclusions:

  • Enucleation of mediastinal lymph nodes is a safe and effective surgical approach for pediatric airway obstruction caused by lymphobronchial tuberculosis.
  • The procedure provides successful relief from obstruction with minimal complications when performed cautiously, avoiding excessive dissection.
Abstract

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