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J Thorac Cardiovasc Surg 2003;126:2090-2092
© 2003 The American Association for Thoracic Surgery

Brief communication

Staged dilation and stenting for long segmental tracheobronchial stenosis caused by tuberculosis

^a Department of SurgeryDivision of Thoracic Surgery, National Taiwan University Hospital, Taipei, Taiwan
^b Department of Pathology, Division of Thoracic Surgery, National Taiwan University Hospital, Taipei, Taiwan

Received for publication May 14, 2003; accepted for publication July 30, 2003.

^* Address for reprints: Yung-Chie Lee, MD, PhD, Division of Thoracic Surgery, Department of Surgery, National Taiwan University Hospital, No. 7, Chung-Shan S. Rd, Taipei, Taiwan
wuj@ha.mc.ntu.edu.tw

The first 20% of the full text of this article appears below.

Endobronchial tuberculosis is defined as tuberculosis of the tracheobronchial tree (TTBT) with microbiological evidence. The estimated prevalence of this complication in patients with pulmonary tuberculosis is 10% to 40%, and more than 90% of patients with endobronchial tuberculosis have some degree of bronchial stenosis.¹ TTBT, in general, is known for its propensity for longer segmental involvement. Despite adequate antituberculosis therapy, tracheobronchial stenosis may develop.² Although several therapeutic approaches, including antituberculous chemotherapy combined with steroids, balloon dilation, laser photoresection, and surgical resection, have been attempted in these patients, the results are largely unsatisfactory.^1,2 Long-segment tracheobronchial stenosis (LTBS) provides a complex challenge to stenting,³ but staged stenting can offer an attractive alternative to standard LTBS therapy.

We report a method of staged stenting used to periodically dilate the stenotic area, and this method is contrary to accepted recommendations for the insertion of single stent or double stents. Because the site is problematic to manage and reobstruction of the airway is likely, repeated dilation and stenting is an appealing option.

Clinical summary

From February 2001 through May 2002, 3 patients (ages 28, 44, and 62 years; 2 women and 1 man) with tuberculosis had severe airway obstruction and were treated at our institution. The diagnosis of LTBS was considered if chest radiograph or sputum culture was positive for tuberculosis and bronchoscopy and computed . . . [Full Text of this Article]

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				B. Smati, M. S. Boudaya, A. Ayadi, J. Ammar, H. Djilani, F. E. Mezni, and T. Kilani Tuberculosis of the Trachea Ann. Thorac. Surg., November 1, 2006; 82(5): 1900 - 1901. [Abstract] [Full Text] [PDF]

				P. Jaiswal, D. Whitaker, L. Lang-Lazdunski, and A. Coonar Stenting for tracheobronchial stenosis in tuberculosis J R Soc Med, January 1, 2005; 98(1): 26 - 28. [Full Text] [PDF]