Abstract

CASTRO ALTUNA, Antonio Alexander; CALLE DELGADO, Catalina Alexandra  and  MACIAS JALKH, Eddyn Rubén. Tratamiento endoscópico de una estenosis traqueal post secuelas de tuberculosis con argón-plasma: Una nueva opción terapéutica en Ecuador. Rev. am. med. respir. [online]. 2014, vol.14, n.1, pp.53-60. ISSN 1852-236X.

Benign strictures of the trachea and bronchi remain a significant clinical problem. Such strictures have different causes; their most frequent causes are prolonged intubation, toxic inhalations, chest trauma and tracheobronchial tuberculosis. Less frequent causes are polychondritis, Wegener's granulomatosis or amyloidosis. It should also be mentioned the scar stenosis in patients with lung cancer, who received radiotherapy or brachytherapy, the endobronchial obstruction by malignant lesions, and less often by carcinoma in situ. Initial symptoms are often nonspecific, such as cough and dyspnea; recording a detailed history is vital to guide diagnosis. Depending on the degree of stenosis, stridor may appear. If the stenosis is not treated, post-obstructive pneumonia, atelectasis and even respiratory arrest and death may appear. In recent years, new alternatives have been explored with endoscopic treatment; the gradual introduction of endobronchial treatments such as laser, electrocautery and argon-plasma-coagulation, have contributed to decreasing the use of surgical techniques and thus reducing significant adverse effects because of a low rate of morbidity and mortality. Here we present the first experience in our country of interventional bronchoscopy with argon-plasma-coagulation in a woman of 27 years of age with a clinical history of laryngeal tuberculosis who presented dysphonia, retrosternal chest pain and dyspnea for a period of four months. The patient underwent tracheostomy in the first instance and then had two sessions with argon-plasma-coagulation with good results.

Keywords : Stenosis; Trachea; Interventional bronchoscopy; Argon-plasma-coagulation; Tuberculosis.

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