Tuberc Respir Dis.  2009 Jun;66(6):431-436.

The Role of Ballooning in Patients with Post-tuberculosis Bronchial Stenosis

• Kwon YS
• Kim H
• Kang KW
• Koh WJ
• Suh GY
• Chung MP
• Kwon OJ

Abstract

BACKGROUND: In order to access the role of ballooning in patients with post-tuberculosis bronchial stenosis (PTBS), medical records of patients who underwent the procedure were reviewed.
METHODS
Twenty-nine PTBS patients underwent balloon dilatation between May 1999 and November 2000 at Samsung Medical Center. The median age was 28 (range 16~62 year) and most patients were female (n=27, 93%). The mean number of ballooning procedures was 2.4 (range 1~8) and the interval between ballooning procedures was 76.2+/-69.7 days.
RESULTS
In general, the FEV1 was improved after ballooning (from 66.2.+/-11.9% predicted to 73.5+/-13.0% predicted, p=0.0004). Among 29 patients who underwent ballooning, a clinically successful outcome was observed in 16 patients (55%). Comparison between the successful and unsuccessful groups showed that favorable factors for a successful outcome were a higher pre-ballooning FEV1 (71.1+/-8.1 vs. 60.2+/-13.3% predicted), higher post-ballooning FEV1 (89.2+/-7.8 vs. 63.4+/-9.2% predicted) and absence of left upper lobe collapse. The clinical outcome was unsuccessful in all eight patients with a pre-ballooning FEV1 < or =57% of predicted or with complete left upper lobe collapse.
CONCLUSION
In conclusion, ballooning appears to be helpful in patients with PTBS, especially when the pre-ballooning FEV1 >57% of predicted and there is no complete left upper lobe lung collapse.

Keyword

Airway obstruction; Balloon dilatation; Bronchoscopy

MeSH Terms

Airway Obstruction
Bronchoscopy
Constriction, Pathologic
Dilatation
Female
Humans
Medical Records
Pulmonary Atelectasis

Figure

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  Figure 1 A three dimensional CT scan in a patient with post tuberculosis bronchial stenosis (PTBS). The proximal left main bronchus was markedly narrowed.

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  Figure 2 Serial bronchoscopic pictures in a patient with post tuberculosis bronchial stenosis (PTBS). Compared to baseline (A), the left main bronchus was step by step widened just before the second (B) and third (C) ballooning.

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  Figure 3 Spirometric data of 29 patients before and after ballooning. Both FEV1 and FVC improved after ballooning compared to baseline.

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  Figure 4 Spirometric data of patients before and after ballooning according to clinical outcome. In the successful group of patients, the baseline FEV1 was more than 57% of predicted.

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