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Ann Thorac Surg 1999;68:1182-1186
© 1999 The Society of Thoracic Surgeons

Original Articles

Surgical management of airway obstruction in primary tuberculosis in children

Konstantinos A. Papagiannopoulos, MMEDa, Anthony G. Linegar, FCS (SA)a, David G. Harris, FCS (SA)a, Gawie J. Rossouw, FCS (SA)a

a Department of Cardiothoracic Surgery, University of Stellenbosch, Tygerberg Hospital, Cape Town, South Africa

Address reprint requests to Dr Papagiannopoulos, 27 Ag. Anargyron Str, Marousi, 151 24, Athens, Greece
e-mail: kpapagiannopoulos{at}yahoo.com

Background. The role of surgery in the management of airway obstruction from lymphobronchial tuberculosis is discussed in the present article.

Methods. Nine patients were operated on over a 4-year period and are currently presented. The age of the patients ranged between 5 and 28 months and 7 patients were male. Six patients required preoperative ventilation due to respiratory failure and all received standard posterolateral thoracotomies. Partial dissection and enucleation of bulky lymph nodes was performed in all but 1 patient. In that patient, the group of lymph nodes could be removed fully, including the sheath.

Results. All patients showed marked improvement and were weaned off the ventilator between 24 and 72 hours postoperatively. Long term follow-up was available in 7 patients and they are all doing well and are free of symptoms.

Conclusions. Enucleation of mediastinal lymph nodes obstructing the airways in young patients with lymphobronchial tuberculosis is safe. It successfully relieves obstruction and is devoid of complication providing that incision, evacuation, and curettage of lymph nodes is performed avoiding overzealous dissection.






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