Huan Nai-Chien, Ng Khai Lip, Nasaruddin Mona Zaria, Muhammad Noorul Afidza, Daut Ummi Nadira, Abdul Rahaman Jamalul Azizi
Department of Pulmonology Serdang Hospital Kajang Malaysia.
Department of Medicine Universiti Putra Malaysia Kajang Malaysia.
Respirol Case Rep. 2021 Jan 25;9(3):e00711. doi: 10.1002/rcr2.711. eCollection 2021 Mar.
Tracheobronchial stenosis secondary to endobronchial tuberculosis (TSTB) is a rare but debilitating complication of endobronchial tuberculosis (EBTB). Topical mitomycin-C (TMC) has been successfully utilized to restore airway patency and to prevent recurrence of TSTB, although little is known about its exact efficacy. Here, we report the biggest case series to date involving seven patients who received TMC as part of multimodality endoscopic treatment for TSTB with varying levels of success. All patients presented with dyspnoea during or after treatment completion for pulmonary tuberculosis (PTB). Four patients had short-segment concentric membranous TSTB while two patients had concurrent bronchomalacia. Another one patient had a thick fibrotic band adjacent to luminal opening. We hypothesize that TMC is more efficacious in short membranous stenosis without concurrent bronchomalacia and/or thick fibrotic bands. More studies are needed to bridge the current gaps in knowledge regarding the optimal role and benefits of TMC for TSTB patients.
支气管内膜结核继发气管支气管狭窄（TSTB）是支气管内膜结核（EBTB）一种罕见但使人衰弱的并发症。局部使用丝裂霉素C（TMC）已成功用于恢复气道通畅并预防TSTB复发，尽管对其确切疗效知之甚少。在此，我们报告了迄今为止最大的病例系列，涉及7例接受TMC作为TSTB多模式内镜治疗一部分的患者，治疗效果各异。所有患者在肺结核（PTB）治疗期间或完成后均出现呼吸困难。4例患者患有短节段同心膜性TSTB，2例患者并发支气管软化。另1例患者在管腔开口处有一条增厚的纤维化带。我们推测TMC在无并发支气管软化和/或增厚纤维化带的短膜性狭窄中更有效。需要更多研究来填补目前关于TMC对TSTB患者的最佳作用和益处的知识空白。
