Abstract:

Objective To evaluate the safety and effectiveness of bronchoscopy in the treatment of lymph node fistula tracheobronchial tuberculosis (TBTB) in children. Methods The basic information, bronchoscopic characteristics of lesions, efficacy, frequency and complications of bronchoscopic treatment of 130 children with lymph node fistula TBTB admitted in Beijing Children’s Hospital affiliated Capital Medical University between January 2012 and December 2019 were retrospectively analyzed. All the children were treated with bronchoscope clamp combined with lavage and local spray. The safety and effectiveness of these treatment were analyzed. Results Of the 130 children, 88 were male (67.7%) and 42 were female (32.3%). The age ranged from 1 month to 12 years, with 86.9% (113/130) <5 years old. A total of 281 lymph node fistula lesions were involved and mainly located on right and upper lobe bronchus. The median (quartile) of lesions number in children aged ≤1 year old was 2.0 (1.0, 4.0), which was significantly higher than that in children aged >1 year old (2.0 (1.0, 2.0), U=1514.000, P=0.004). The overall effective rate of bronchoscope clamp combined with lavage and local spray was 95.4% (124/130). The number of interventions (median (quartile)) was 6.0 (3.8, 9.0). The number of interventions (median (quartile)) in children with single lesion was 3.0 (2.0, 5.0) times, which was significantly lower than that in children with multiple lesions (8.0 (5.0, 10.0), U=581.500, P<0.01). There were no serious complications during or after the treatment. All the children were followed up more than 6 months, and no recurrence was observed. Conclusion Bronchoscope clamp combined with lavage and local spray was of good effect and safety for lymph node fistula TBTB in children.

Key words: Tuberculosis, Trachea, Bronchi, Child, Bronchoscopy