Complicated intrathoracic tuberculosis: Role of therapeutic interventional bronchoscopy

Pierre Goussard; Ernst Eber; Shyam Venkatakrishna; Lisa Frigati; Jacques Janson; Pawel Schubert; Savvas Andronikou

doi:10.1016/j.prrv.2022.12.001

Complicated intrathoracic tuberculosis: Role of therapeutic interventional bronchoscopy

Paediatr Respir Rev. 2023 Mar:45:30-44. doi: 10.1016/j.prrv.2022.12.001. Epub 2022 Dec 17.

Authors

Pierre Goussard¹, Ernst Eber², Shyam Venkatakrishna³, Lisa Frigati⁴, Jacques Janson⁵, Pawel Schubert⁶, Savvas Andronikou³

Affiliations

¹ Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg Hospital, Cape Town, South Africa. Electronic address: pgouss@sun.ac.za.
² Division of Paediatric Pulmonology and Allergology, Department of Paediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria.
³ Department of Pediatric Radiology, The Children's Hospital of Philadelphia, Philadelphia, PA, USA; Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
⁴ Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg Hospital, Cape Town, South Africa.
⁵ Department of Surgical Sciences, Division of Cardiothoracic Surgery, Stellenbosch University, and Tygerberg Hospital, Tygerberg, South Africa.
⁶ Division of Anatomical Pathology, Tygerberg Hospital, National Health Laboratory Service, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.

PMID: 36635200
DOI: 10.1016/j.prrv.2022.12.001

Abstract

In recent years bronchoscopy equipment has been improved with smaller instruments and larger size working channels. This has ensured that bronchoscopy offers both therapeutic and interventional options. As the experience of paediatric interventional pulmonologists continues to grow, more interventions are being performed. There is a scarcity of published evidence in the field of interventional bronchoscopy in paediatrics. This is even more relevant for complicated pulmonary tuberculosis (PTB). Therapeutic interventional bronchoscopy procedures can be used in the management of complicated tuberculosis, including for endoscopic enucleations, closure of fistulas, dilatations of bronchial stenosis and severe haemoptysis. Endoscopic therapeutic procedures in children with complicated TB may prevent thoracotomy. If done carefully these interventional procedures have a low complication rate.

Keywords: Flexible bronchoscopy; Interventional bronchoscopy; Pulmonary tuberculosis; Rigid bronchoscopy; Xpert MTB/RIF.

Publication types

Review

MeSH terms

Bronchoscopy
Child
Humans
Mycobacterium tuberculosis*
Sputum
Tuberculosis*
Tuberculosis, Pulmonary*