Efficacy and safety of CO2 cryotherapy in the treatment of infants with tracheobronchial tuberculosis

Abstract

ObjectiveThis study aimed to investigate the efficacy and safety of CO2 cryotherapy for lymph node fistula tracheobronchial tuberculosis (TBTB) in infants.Patients and methodsA retrospective analysis was undertaken on seven patients with lymph node fistula tracheobronchial tuberculosis who underwent fiberoptic bronchoscopy (FB) interventional therapy in the respiratory department of Tianjin Children's Hospital from July 2012 to July 2020. The efficacy, safety, and prognosis of CO2 cryotherapy intervention for the treatment of lymph node fistula TBTB in infants were summarized and analyzed.ResultsSeven patients with lymph node fistula TBTB were included in this study. Their ages ranged from 6–13 months. The course of the disease from onset to TBTB ranged from 20 to 70 days. The pathological diagnoses of seven cases by FB combined with tissue biopsy were lymph node fistula TBTB, of which 28.57% (two cases) were in the early stage of rupture and 71.43% (five cases) were in the rupture stage. All patients were treated with CO2 cryotherapy combined with foreign body forceps and local injection drugs based on systemic antituberculosis chemotherapy. Two patients were treated once with CO2 cryotherapy, and five were treated three times. According to the comparison of the clinical symptoms, imaging results, and endoscopic presentations before and after the intervention, six patients achieved clinical cure, and one achieved clinical improvement. No severe intraoperative or postoperative complications were observed. The clinical symptoms, endoscopic findings, radiological manifestations, and quality of life of all patients showed marked improvement. No recurrence occurred after 3–6 months of follow-up with FB.ConclusionCO2 cryotherapy can improve the treatment effect of lymph node fistula in infants with TBTB and reduce the incidence of complications. This treatment is safe and reliable in infants.

Cryoprobe for Endoscopic Enucleation in Children with Pulmonary Tuberculosis: Effective but Not Without Danger – Case Report and Review of Literature

“…It can be used for lung biopsy, creating airway patency, biopsy and removal of endobronchial lesions, and extraction of foreign bodies. A cryoprobe can be used to perform endobronchial biopsy for TB diagnosis [7,8]. The potential advantage of the cryoprobe is that it can be used even in small children due to the availability of 1.1 mm and 1.9 mm probes.…”

“…There are very limited reports on the use of cryotherapy in PTB, but Zhao et al [8] have reported on seven children with lymph node fistulas with TB. They have reported that both caseous material and the combination of granulation tissue with caseous material can be effectively removed to improve airway patency.…”

“…All patients were treated with CO 2 cryotherapy combined with foreign body forceps and local injection of drugs based on systemic antituberculosis chemotherapy. CO 2 cryotherapy was reported to improve the treatment efficacy for lymph node fistulas in infants with TB and to reduce the incidence of complications [8].…”