Interventional bronchoscopy in pediatric pulmonary tuberculosis.

Expert review of respiratory medicine Pub Date : 2023-12-01 Epub Date: 2023-12-28 DOI:10.1080/17476348.2023.2299336
Pierre Goussard, Ernst Eber, Shyam Venkatakrishna, Lisa Frigati, Leonore Greybe, Jacques Janson, Pawel Schubert, Savvas Andronikou
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Abstract

Introduction: Lymphobronchial tuberculosis (TB) is common in children with primary TB and enlarged lymph nodes can cause airway compression of the large airways. If not treated correctly, airway compression can result in persistent and permanent parenchymal pathology, as well as irreversible lung destruction. Bronchoscopy was originally used to collect diagnostic samples; however, its role has evolved, and it is now used as an interventional tool in the diagnosis and management of complicated airway disease. Endoscopic treatment guidelines for children with TB are scarce.

Areas covered: The role of interventional bronchoscopy in the diagnosis and management of complicated pulmonary TB will be discussed. This review will provide practical insights into how and when to perform interventional procedures in children with complicated TB for both diagnostic and therapeutic purposes. This discussion incorporates current scientific evidence and refers to adult literature, as some of the interventions have only been done in adults but may have a role in children. Limitations and future perspectives will be examined.

Expert opinion: Pediatric pulmonary TB lends itself to endoscopic interventions as it is a disease with a good outcome if treated correctly. However, interventions must be limited to safeguard the parenchyma and prevent permanent damage.

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小儿肺结核的介入性支气管镜检查。
导言:淋巴支气管结核(TB)是原发性肺结核患儿的常见病,肿大的淋巴结可导致大气管受压。如果治疗不当,气道受压会导致持续性和永久性的实质病变,以及不可逆的肺部破坏。支气管镜最初用于采集诊断样本,但其作用已发生变化,现在已成为诊断和治疗复杂气道疾病的介入性工具。针对结核病患儿的内窥镜治疗指南还很少:将讨论介入性支气管镜在诊断和治疗复杂肺结核中的作用。这篇综述将就如何以及何时对患有复杂肺结核的儿童实施介入手术以达到诊断和治疗目的提供实用的见解。讨论将纳入当前的科学证据,并参考成人文献,因为有些干预措施只在成人中进行过,但可能对儿童有作用。此外,还将探讨其局限性和未来展望:专家意见:小儿肺结核适合内窥镜干预,因为这种疾病如果治疗得当,疗效会很好。但是,干预必须有限度,以保护实质组织,防止永久性损伤。
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