Results Of Bronchoscopic Balloon Dilatation In The Management Of Tuberculous Tracheal Stenosis

Objective:To assess the effectiveness and safety of balloon dilatation through bronchoscopy in the management of tuberculous tracheal stenosis.Methods:To retrospectively analyze the clinical data of 26 patients with tuberculous tracheal stenosis who were hospitalized at Guangzhou Chest Hospital from December 2006 to February 2010, treated by balloon dilatation through bronchoscopy. Before the procedure and immediately after the last operation, airway diameter and FEV1.0 and blood gas were tested,and complications after operation were noted.Patients were followed for 8 to 46 months.Results:26 patients with tuberculous stenosis were treated with multiple drug chemotherapy protocol. 1 to 6 balloon dilation sessions per patient (mean, 2.92±1.49 sessions)were required to achieve satisfactory dilatation. After balloon dilatation, initial symptomatic improvement was achieved in all patients(100%), the average airway diameter increased(5.00±1.52 mm vs 10.65±1.81 mm), FEV1.0 increased(1.18±0.33 L vs 2.08±0.40 L), PaO2 heightened(53.40±6.00 mmHg vs 89.55±7.50 mmHg), PaCO2 declined(48.90±5.10 mmHg vs 36.75±1.95 mmHg), SaO2 improved (84.68±3.67% vs 97.91±1.41%). Procedure-related major complication is pneumothorax, which occurred in two patients. No other severe complications were found in these patients. During the follow-up period, 18 of 26 patients (69%) recovered from their airway stenosis, but 8 of them experienced recurrence of their symptoms. 5 patients of restenosis were controlled in good condition with high-frequency electric cautery and cryotherapy and forceps clipping. 3 patients of restenosis treated with high-frequency electric cautery and balloon dilatation repeatly. 18 of the 21 tuberculous tracheal stenosis with scarring patients (86%) treated alone with balloon dilatation to keep their airway opening , couldn't need any other form of therapeutic intervention.Conclusion:Balloon dilatation through bronchoscopy is a simple but effective and safe method to treat tuberculous tracheal stenosis.It is worth extending.