Multimodality endoscopic treatment for tracheobronchial stenosis secondary to endobronchial tuberculosis
Introduction: Tracheobronchial stenosis secondary to endobronchial tuberculosis (TSTB) is a rare but devastating complication of TB. Endoscopic interventions (EI) might be an attractive alternative for patients unfit for surgery but little is known on whether the efficacy of EI can be affected by ai...
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| Format: | Article |
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European Respiratory Society
2021
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| author | Nai, Chien Huan Khai, Lip Ng Mohammad, Fatimah Azmah Mohd Aminudin, Nur Husna Muhammad, Noorul Afidza Daut, Ummi Nadira Nasaruddin, Mona Zaria Abdul Rahaman, Jamalul Azizi |
| author_facet | Nai, Chien Huan Khai, Lip Ng Mohammad, Fatimah Azmah Mohd Aminudin, Nur Husna Muhammad, Noorul Afidza Daut, Ummi Nadira Nasaruddin, Mona Zaria Abdul Rahaman, Jamalul Azizi |
| author_sort | Nai, Chien Huan |
| collection | UPM |
| description | Introduction: Tracheobronchial stenosis secondary to endobronchial tuberculosis (TSTB) is a rare but devastating complication of TB. Endoscopic interventions (EI) might be an attractive alternative for patients unfit for surgery but little is known on whether the efficacy of EI can be affected by airway features.
Methods: Retrospective study of EI performed for TSTB patients at interventional pulmonology unit of Serdang Hospital, Malaysia.
Results: Our cohort comprised of 9 patients with mean age of 33.9years (SD10.43). All had dyspnoea, 33% had stridor, 44% had cough. Of CT and bronchoscopy performed, 67% had tracheal stenosis, 44% right main bronchus involvement, 22% left main bronchus involvement. 33% had multilevel airway involvement. Of airway features, 67% had pure short segment membranous concentric stenosis. Remaining 33% had extra adverse airway features (22% bronchomalacia;11% thick fibrotic band). All cases were performed with rigid bronchoscopy under general anaesthesia. All underwent balloon dilatation of stenotic segment; 78% had topical mitomycin-c (TMC) application and 11% did mechanical coring of stenotic segment. Procedure was deemed successful (sustained symptomatic benefits of ≥3 months) in 67% cases. All unsuccessful cases had adverse airway features. Of complications, 22% developed self-limiting airway tear (0.5cm) during procedure. None developed TMC related complications.
Conclusion: EI appears to be an attactive option for TSTB patients. We postulate that EI might produce more sustainable benefits in those with pure short membranous concentric stenosis without adverse airway features. Future studies are needed to define the exact role of EI for TSTB patients. |
| first_indexed | 2024-03-06T10:59:28Z |
| format | Article |
| id | upm.eprints-94291 |
| institution | Universiti Putra Malaysia |
| last_indexed | 2024-03-06T10:59:28Z |
| publishDate | 2021 |
| publisher | European Respiratory Society |
| record_format | dspace |
| spelling | upm.eprints-942912023-05-03T09:01:54Z http://psasir.upm.edu.my/id/eprint/94291/ Multimodality endoscopic treatment for tracheobronchial stenosis secondary to endobronchial tuberculosis Nai, Chien Huan Khai, Lip Ng Mohammad, Fatimah Azmah Mohd Aminudin, Nur Husna Muhammad, Noorul Afidza Daut, Ummi Nadira Nasaruddin, Mona Zaria Abdul Rahaman, Jamalul Azizi Introduction: Tracheobronchial stenosis secondary to endobronchial tuberculosis (TSTB) is a rare but devastating complication of TB. Endoscopic interventions (EI) might be an attractive alternative for patients unfit for surgery but little is known on whether the efficacy of EI can be affected by airway features. Methods: Retrospective study of EI performed for TSTB patients at interventional pulmonology unit of Serdang Hospital, Malaysia. Results: Our cohort comprised of 9 patients with mean age of 33.9years (SD10.43). All had dyspnoea, 33% had stridor, 44% had cough. Of CT and bronchoscopy performed, 67% had tracheal stenosis, 44% right main bronchus involvement, 22% left main bronchus involvement. 33% had multilevel airway involvement. Of airway features, 67% had pure short segment membranous concentric stenosis. Remaining 33% had extra adverse airway features (22% bronchomalacia;11% thick fibrotic band). All cases were performed with rigid bronchoscopy under general anaesthesia. All underwent balloon dilatation of stenotic segment; 78% had topical mitomycin-c (TMC) application and 11% did mechanical coring of stenotic segment. Procedure was deemed successful (sustained symptomatic benefits of ≥3 months) in 67% cases. All unsuccessful cases had adverse airway features. Of complications, 22% developed self-limiting airway tear (0.5cm) during procedure. None developed TMC related complications. Conclusion: EI appears to be an attactive option for TSTB patients. We postulate that EI might produce more sustainable benefits in those with pure short membranous concentric stenosis without adverse airway features. Future studies are needed to define the exact role of EI for TSTB patients. European Respiratory Society 2021-11-25 Article PeerReviewed Nai, Chien Huan and Khai, Lip Ng and Mohammad, Fatimah Azmah and Mohd Aminudin, Nur Husna and Muhammad, Noorul Afidza and Daut, Ummi Nadira and Nasaruddin, Mona Zaria and Abdul Rahaman, Jamalul Azizi (2021) Multimodality endoscopic treatment for tracheobronchial stenosis secondary to endobronchial tuberculosis. European Respiratory Journal, 58 (suppl. 65). art. no. PA855. ISSN 0903-1936; ESSN: 1399-3003 https://erj.ersjournals.com/content/58/suppl_65/PA855.article-info 10.1183/13993003.congress-2021.PA855 |
| spellingShingle | Nai, Chien Huan Khai, Lip Ng Mohammad, Fatimah Azmah Mohd Aminudin, Nur Husna Muhammad, Noorul Afidza Daut, Ummi Nadira Nasaruddin, Mona Zaria Abdul Rahaman, Jamalul Azizi Multimodality endoscopic treatment for tracheobronchial stenosis secondary to endobronchial tuberculosis |
| title | Multimodality endoscopic treatment for tracheobronchial stenosis secondary to endobronchial tuberculosis |
| title_full | Multimodality endoscopic treatment for tracheobronchial stenosis secondary to endobronchial tuberculosis |
| title_fullStr | Multimodality endoscopic treatment for tracheobronchial stenosis secondary to endobronchial tuberculosis |
| title_full_unstemmed | Multimodality endoscopic treatment for tracheobronchial stenosis secondary to endobronchial tuberculosis |
| title_short | Multimodality endoscopic treatment for tracheobronchial stenosis secondary to endobronchial tuberculosis |
| title_sort | multimodality endoscopic treatment for tracheobronchial stenosis secondary to endobronchial tuberculosis |
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