Tuberculous stenosis of the left main bronchus: results of treatment with balloons and metallic stents.

PURPOSE: To assess the results of treatment with balloon dilation and metallic Z stents in patients with tuberculous stenosis of the left main bronchus.

MATERIALS AND

METHODS

Nineteen patients with tuberculous stenosis of the left main bronchus were treated with balloon (n = 15) and self-expanding metallic Z stents (n = 4). Respiratory status and pulmonary function tests were followed up for 2-90 months.

RESULTS

In the balloon group, improvements in dyspnea occurred in 73% (11 of 15 patients) immediately, 73% after 1 month, 73% after 6 months, 64% after 1 year, 64% after 3 years, and 42% after 6 years (Kaplan-Meier method). Improvement of pulmonary function (FEV1 or FVC) was achieved in 62% (eight of 13) after 1 year. In the stent group, immediate improvements of dyspnea or pulmonary function occurred in all patients. However, fracture of the stents occurred in two patients, at 4 and 18 months, respectively. Occlusion of the lumen of the stent by granulation tissue occurred in another at 18 months.

CONCLUSION

Balloon dilation can be an effective method for the treatment of tuberculous stenosis of the main bronchus. Metallic Z stents should be used cautiously because of their problems of mechanical durability and overgrowth of granulation tissue.