• Tuberculosis and Respiratory Diseases
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• v.41 no.1
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• pp.47-50
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• 1994

To maintain an adequate airway in a patient with tracheobronchial narrowing coming from various causes, prosthetic tracheobronchial stents provide palliative treatment for narrowed airways where surgical resection is inadvisable. After insertion, previous reported complications were granuloma formation, dysphagia, suction catheter entrapment and fatal massive hemoptysis. We report, a case of complication associated with expandible metallic stent with endobronchial stenosis due to tuberculosis.

• Journal of Chest Surgery
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• v.25 no.11
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• pp.1299-1304
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• 1992

We experienced 5 cases of tracheal stenosis and 7 cases bronchial stenosis treated surgically at the Department of Thoracic and Cardiovascular Surgery, School of Medicine, Hanyang University during 5 years. The causes of tracheal stenosis were prolonged endotracheal intubation 1 case, tracheostomy 1 case, the sequela of endobronchial tuberculosis 2 cases and tracheomalacia 1 case. The causes of bronchial stenosis were all endobronchial tuberculosis. The managements of tracheal stenosis were tracheal resection and end to end anastomosis. The resected lengths of trachea were 1.5cm, 3cm and 7.5cm. One case of suglottic stenosis was underwent the resection of trachea, 8cm in length, and the laryngotracheal anastomosis was done, but the re-stenosis of trachea was developed after 4 weeks post-operatively. One case of tracheomalacia was done permanent tracheostomy only, because the entire trachea was adhered to the surrounding tissue. The managements of bronchial stenosis were resection of involved lobe or one lung, in the 5 case. One case with Lt. main bronchial stenosis and atelectasis of Lt. upper lobe was done the lobectomy of Lt. upper lobe only and then, the Lt. pneumonectomy was done re-operatively because the atelectasis of Lt. lower lobe had continued. The other one case with stenosis of Rt. main bronchus, failed the insertion of metalic stent, was underwent the Rt. upper lobe lobectomy, sleeve resection and side to end anastomosis

• Tuberculosis and Respiratory Diseases
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• v.38 no.3
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• pp.236-244
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• 1991

The prevalence rate of pulmonary tuberculosis is 1.8% in 1990, and endobronchial tuberculosis may exist in 10 to 40% of active disease. Endobronchial tuberculosis usually leaves bronchial stenosis as the complication despite of modern chemotherapy, and it is often misdiagnosed as bronchial asthma. When bronchial stenosis involves major airway, its treatment needs such special measures as steroid therapy, surgical intervention and/or laser therapy, but the therapeutic result is often disappointing. To exploit a new treatment modality for bronchial stenosis, balloon dilatation was carried out in 12 patients with endobronchial tuberculosis. Under local anesthesia, 4F-Fogarty balloon was inserted via bronchofiberscope in ten cases and 10F-Gruentzig balloon was introduced under fluoroscopic guide in two others. Endobronchial tuberculoses were subdivided into two(16.7%) with actively caseating type, seven (58.3%) with fibrostenotic type, and three (25.0%) with stenotic type without fibrosis, according to the bronchoscopic findings. In 7 healed cases which were all stenotic with fibrosis, three (42.9%) took favorable turn in clinical status but four (57.1%) were not improved with balloon dilatation. In 5 active cases, all (two with actively-caseating type and three with stenotic type without fibrosis) were improved with this method. $FEV_{1.0}$ or FVC increased 10% or more after procedure in seven (70.0%) of ten and bronchial lumen remained enlarged in eight (66.7%) of twelve, in whom follow-up examination was done after the procedure. Balloon dilatation of bronchial stenosis is more effective, when endobronchial tuberculosis is in active stage than in healed fibrotic stage. It is suggested that bronchial stenosis can be minimized by early diagnosis and early application of balloon dilatation in the course of disease.

• Journal of Chest Surgery
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• v.33 no.4
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• pp.320-323
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• 2000

This case describes a tracheal stenosis complicated by endobronchial truberculosis. A 50-year-old female with progressive dyspnea was referred to us for the management of long segmental tracheal stenosis. Treatment modalities for tracheal stenosis include open surgical resectin and reconstruction, mechanical dilation, laser resection, and placement of an airway prosthesis. The following is a report of a successful treatment of a long segmental tracheal stenosis through a tracheal augmentation and the use of al Bovine pericardium. This technique may provide a relief from tracheal stenosis.

• Tuberculosis and Respiratory Diseases
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• v.38 no.2
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• pp.108-115
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• 1991

Endobronchial tuberculosis is a serious disease which is frequently complicated with bronchial stenosis, and it may simulate a bronchial asthma or bronchogenic carcinoma. We have analyzed the clinical characteristics of endobronchial tuberculosis in 166 patients, and we introduce new classification of endobronchial tuberculosis. Endobronchial tuberculosis is classified into seven subtypes as stenotic type with fibrosis, stenotic type without fibrosis, actively caseating type, tumorous type, ulcerative type, granular type and nonspecific bronchitic type, according to the bronchoscopic findings. Actively caseaing type, stenotic type without fibrosis, nonspecific bronchitic type and stenotic type with fibrosis are predominant in the order of frequency, but ulcerative type and granular type are relatively rare. Stenotic type with or without fibrosis, actively caseating type and tumorous type of endobronchial tuberculosis are closely related to bronchial stenoses. We believe that our new classification of endobronchial tuberculosis, which is based on bronchoscopic features, is helpful to understand the pathogenesis of disease and to make a therapeutic plan for preventing or minimizing bronchial stenosis.

• Tuberculosis and Respiratory Diseases
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• v.75 no.2
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• pp.79-82
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• 2013

Tracheal Stenosis after Tracheostomy Treated Successfully with Papillotome Electrocautery A 39-year-old woman presented with symptoms of dyspnea. Ten years previously, she had received a tracheostomy because of the decision to not continue taking an anticonvulsant drug. Presently, chest computed tomography showed diffuse stenosis and focal web at the cervical trachea. We performed bronchoscopy and found a two-thirds reduction of the upper trachea due to the web-like fibrotic stenosis. Papillotome electrocautery removed the stenotic lesion. Endobronchial electrocautery is a valuable tool with potential for therapy of an endobronchial obstructing airway lesion. We report this case to introduce the successful treatment with papillotome electrocautery.

• Journal of Chest Surgery
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• v.42 no.5
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• pp.670-673
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• 2009

A 20 year old woman had developed stenosis at the lower part of the trachea, right main bronchus, and right upper lobe bronchus as a complication of endobronchial tuberculosis. The patient had complained of severe dyspnea. Tracheobronchial stenosis was so extensive that we did reconstruction of the trachea and right bronchus with resection of the lower trachea and right main bronchus and right upper lobectomy. She has been doing well without any respiratory symptoms or complications.

• Tuberculosis and Respiratory Diseases
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• v.38 no.4
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• pp.347-356
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• 1991

Endobronchial tuberculosis is a serious disase because it frequently leaves airway obstruction as the complication, and the treatment of airway obstruction is generally troublesome. In the tumorous type of endobonchial tuberculosis, the bronchial patency is partially or completely compromised with lymph node contents when the necrotic focus of the lymph node ruptures into the bronchial lumen to form a bronchoglandular fistula. To investigate the transition of endobronchial lesion and to evaluate the therapeutic role of bronchoscopic electrocautery in the tumorous type of endobronchial tuberculosis, we performed electrocautery in addition to the combination chemotherapy with steroid and anti-tuberculous drugs in two cases which had airway obstruction proximal to lobar bronchus with the impairment of pulmonary function. We also treated another two cases only with chemotherapy and we have followed up four cases over a 36-month period. In cases that bronchoscopic electrocautery was done, the bronchial patency was completely restored and the impairment of pulmonary function disappeared just after cautery and these effects have remained for 12 months or more. But in cases of medical treatment only, bronchial stenosis was inevitable as the tumorous type of endobronchial tuberculosis changed to the stenotic type with fibrosis. It can be concluded that bronchoscopic electrocautery can nip the occurence of bronchial stenosis in the bud when it is applied in addition to combination chemotherapy with steroid and antituberculous drugs in the tumorous type of endobronchial tuberculosis.

• Journal of Chest Surgery
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• v.34 no.8
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• pp.640-643
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• 2001

A case of endobronchial tuberculosis with left main bronchial stenosis and atelectasis of left lower lobe in a 26-year-old female is reported. She had taken antituberclous agents for 9 months, but she complained of chest pain and coughing. Bronchoscopy revealed patency of left upper bronchus and bronchiectasis of left lower lobe. She underwent left lower lobectomy with bronchoplasty. After the operation she had significant improvement of pulmonary function. Although surgical treatment of endobronchial tuberculosis is controversial, bronchoplastic surgery can be an effective treatment of tuberculous bronchial stenosis because it relieves patients from symptoms by preserving lung functions.

• Tuberculosis and Respiratory Diseases
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• v.78 no.3
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• pp.286-288
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• 2015

Endobronchial tuberculosis is defined as a tuberculous infection of the tracheobronchial tree and has a prevalence of up to 50% in active pulmonary tuberculosis cases. The most common complication of endobronchial tuberculosis is bronchial stenosis; benign fistula formation by endobronchial tuberculosis is rare, especially inter-bronchial fistula formation. We reported a rare case of a 73-year-old woman with a fistula between the right upper bronchus and bronchus intermedius. A diagnosis of inter-bronchial fistula caused by endobronchial tuberculosis was based on the results of chest computed tomography scans, bronchoscopy, and microbiological and pathological tests. The patient was treated with anti-tuberculous medication, and her symptoms gradually improved.