Tuberculous tracheobronchial stenosis: avoiding resection-when less is more

A case of tracheobronchial stenosis due to tuberculosis in a young woman is presented. Compromised pulmonary function due to near-total obstruction of the proximal left main bronchus was diagnosed. Treatment options included surgical resection, endobronchial dilation or stenting, and argon photocoagulation. An approach was chosen to address symptoms without aggressive resection or commitment to stenting. She remains monitored and, while possibly committed to future intervention, no bridges have been burned with respect to more definitive and invasive therapies. We propose this "less is more" initial approach in all patients when possible. Reserving the more aggressive alternatives for high-risk surgical candidates and those that have been unresponsive to lesser procedures.