結核性気管支狭窄の外科治療

抄録

In the past eleven years, eight cases of bronchial tuberculosis or tuberculous stricture were operated on. Of the eight cases, the right upper bronchus was involved in three cases, the main and right upper bronchus in three, and the left main bronchus in two cases. These strictures were mostly induced by nonspecific granular tissue after healing of tuberulous bronchitis by anti-tuberculous treatment.
For three cases of cicatrical stricture confined to the orifice of the right upper bronchus without inflammatory changes of the main bronchus, right upper lobectomy were successfully performed without any postoperative complication. However, the three cases of right upper bronchus obstruction with cicatrical stricture or inflammatory changes in the main bronchus underwent sleeve upper lobectomy by resecting the right main bronchus.
In two cases, the left main bronchus were involved. One case developed atelectasis of the entire left lung due to cicatrical occlusion of the main bronchus during anti-tuberculous treatment, pneumonectomy was inevitable. In the other case of the left main bronchus stricture with complete obstruction of the left upper bronchus, the left upper lobe including the left main bronchus was resected, and side to end anastomosis between the trachea and the left lower bronchus was performed.
In the follow-up of the case of bronchial tuberculosis periodical observation by bronchoscopy and examination of respiratory function including flow volume curve should be done. We are considering bronchoplastic surgery should be performed before residual lung tissue were destroyed.