Surgical management of airway obstruction in primary tuberculosis in children.
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.
Papagiannopoulos
K A
KA
Department of Cardiothoracic Surgery, University of Stellenbosch, Tygerberg Hospital, Cape Town, South Africa. kpapagiannopoulos@yahoo.com
Linegar
A G
AG
Harris
D G
DG
Rossouw
G J
GJ
D000402:Airway Obstruction / Q000000981:diagnostic imaging / Q000601:surgery*; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D013908:Thoracotomy; D014057:Tomography, X-Ray Computed; D014388:Tuberculosis, Lymph Node / Q000000981:diagnostic imaging / Q000601:surgery*; D014397:Tuberculosis, Pulmonary / Q000000981:diagnostic imaging / Q000601:surgery*; D015300:Ventilator Weaning