Bronchial stricture due to endobronchial tuberculosis

From 1974 to 1986, there were 14 cases of bronchial stricture or obliteration caused by endobronchial tuberculous lesions. Nine cases had histories of tuberculosis but five were suspected of having malignant respiratory passage obstruction at the initial diagnosis. Five cases were kept under observation because of mildness of the subjective symptoms or refusal of operation. Nine cases underwent operation. As the bronchial lesions in three cases were confined to the lobar or segmental bronchus, lobectomies were done. One case with a history of infantile tuberculosis developed complete obliteration of the left main bronchus and cystic bronchiectasis in the entire lung parenchyma, so pneumonectomy was inevitable. Five cases which had strictures in the main bronchus underwent bronchoplastic surgery. The operative procedures were right sleeve upper lobectomy in four cases and left sleeve upper lobectomy in one case. All of the cases undergoing operation showed no post-operative complication or recurrence of the tuberculosis. The results of our present series of tuberculous bronchial stricture indicate the need for early detection and operation. For the cases with main bronchus involvement, bronchoplastic surgery should be selected as an alternative to pneumonectomy to preserve the pulmonary function.