Three-stage tracheobronchial reconstruction for tuberculous stenosis.

Surgical treatment of tracheobronchial deformities permits conservation of undamaged lung tissue distal to bronchial lesions, and provides a means of treating obstructive tracheal lesions heretofore considered insurmountable. Two methods in this immature surgical field have been used with gratifying success. The first is resection and anastomosis, 1 the second is plastic reconstruction with wire-supported dermal grafts. 2 The first method is useful for small localized lesions, and the second suitable for more extensive deformities. The case described here afforded a severe test for tracheobronchial reconstruction. The relatively new surgical method used provided a solution to a clinical problem in which the distribution of healed lesions of tuberculous tracheobronchitis (which created the problem) was unique. In this case strangulating asphyxiation was gradually progressive for two years until finally an incredible degree of airway obstruction resulted that involved the thoracic trachea as well as both bronchi. Developing rapidly, a similar degree of