Surgical repair for post-tuberculosis tracheobronchial stenosis

Area of Science:

• Thoracic Surgery
• Pulmonary Medicine
• Critical Care Medicine

Background:

• Post-tuberculosis tracheobronchial stenosis is a rare but severe complication of tuberculosis.
• Initial treatments for mild to moderate stenosis include balloon dilatation, stenting, and laser therapy.
• Severe and long-segment stenosis often necessitates surgical intervention.

Purpose of the Study:

• To report a case series of patients with post-tuberculosis tracheobronchial stenosis treated surgically.
• To evaluate the efficacy of segmental resection and end-to-end anastomosis for bronchial stenosis.
• To assess the utility of sliding tracheoplasty for severe, long-segment tracheal stenosis.

Main Methods:

• Retrospective review of medical records for patients with post-tuberculosis tracheobronchial stenosis.
• Seven patients underwent surgical treatment.
• Treatments included segmental resection with end-to-end anastomosis (5 bronchial stenosis cases) and sliding tracheoplasty or resection with anastomosis (2 tracheal stenosis cases).

Main Results:

• All five patients with bronchial stenosis achieved good outcomes with well-ventilated lungs and good respiratory function.
• One patient with tracheal stenosis treated with resection and anastomosis died post-surgery.
• The patient with tracheal stenosis treated with sliding tracheoplasty recovered well.

Conclusions:

• Treatment for post-tuberculosis tracheobronchial stenosis should be individualized.
• Sliding tracheoplasty is a viable surgical option for long-segment tracheal stenosis.
• Segmental resection and end-to-end anastomosis can be effective for bronchial stenosis.