Department of Thoracic Surgery, Cho Ray Hospital, Ho Chi Minh City, Vietnam.
Asian Cardiovasc Thorac Ann. 2021 Jan;29(1):26-32. doi: 10.1177/0218492320963972. Epub 2020 Sep 30.
Post-tuberculosis tracheobronchial stenosis is rare but one of the most dangerous complications of tracheobronchial tuberculosis. Balloon dilatation, stent insertion, laser photoresection, argon plasma coagulation, and cryotherapy are some of the initial treatments recommended for mild to moderate cases. Here, we report a case series of patients who underwent segmental resection and end-to-end anastomosis for bronchial stenosis and a sliding technique for severe and long-segment tracheal stenosis.
We retrospectively reviewed the medical records of patients with post-tuberculosis tracheobronchial stenosis operated on in our thoracic surgery department. Of the 7 cases that were treated, two had severe tracheal stenosis stretching over 50% of the tracheal length, one was operated on using resection and end-to-end anastomosis, and the other had sliding tracheoplasty. The other 5 cases of bronchial stem stenosis were treated with segmental resection and end-to-end anastomosis.
All five patients with bronchial stenosis had a good outcome; the ipsilateral lung was well ventilated and respiratory function was good. One patient with tracheal stenosis, treated with segmental resection and end-to-end anastomosis, died after the surgery, and the other patient, treated with slide tracheoplasty, had a good recovery.
The treatment plan for patients with post-tuberculosis tracheobronchial stenosis should be on a patient-by-patient basis. Sliding tracheoplasty can be a treatment option in patients with long-segment tracheal stenosis.
肺结核后气管支气管狭窄虽罕见，但却是气管支气管结核最危险的并发症之一。对于轻度至中度狭窄，推荐采用球囊扩张、支架置入、激光光切除、氩等离子凝固和冷冻疗法等初始治疗方法。在此，我们报告了一组接受支气管狭窄节段切除端端吻合术和严重长段气管狭窄滑动技术治疗的患者病例系列。
我们回顾性地审查了在我院胸外科手术治疗的肺结核后气管支气管狭窄患者的病历。在接受治疗的 7 例患者中，2 例有超过 50%气管长度的严重气管狭窄，1 例采用切除端端吻合术治疗，1 例采用滑动气管成形术。另外 5 例支气管主干狭窄患者采用节段切除端端吻合术治疗。
所有 5 例支气管狭窄患者均取得良好效果，患侧肺通气良好，呼吸功能良好。1 例采用节段切除端端吻合术治疗的气管狭窄患者术后死亡，另 1 例采用滑动气管成形术治疗的患者恢复良好。
肺结核后气管支气管狭窄患者的治疗方案应根据患者的具体情况而定。滑动气管成形术可作为长段气管狭窄患者的治疗选择之一。
