Between 1974 and 1995 we encountered 19 cases of bronchial stricture o
r obliteration caused by endobronchial tuberculous lesions. In 11 the
involvements were located at the right bronchus (including involvement
s of segmental and middle lobe bronchi) and in 8 at the left bronchus.
On bronchoscopic biopsy of the stenosed bronchus, 7 patients showed h
istopathologic findings of tuberculous bronchitis, but 12 patients sho
wed nonspecific inflammatory granular tissue. Five patients were kept
under conservative observation because of mild subjective symptoms or
refusal to undergo operation. Two patients underwent stent procedures
but had poor outcomes. Twelve patients underwent operation. As the bro
nchial lesions in four of them were confined to the lobar or segmental
bronchus, lobectomy was performed. One patient with a history of infa
ntile tuberculosis had developed complete obliteration of the left mai
n bronchus and cystic bronchiectasis in the entire lung parenchyma; pn
eumonectomy was essential. Seven patients who had strictures involving
the main bronchus underwent bronchoplastic surgery with right (n = 4)
or left (n = 3) upper sleeve lobectomy. None of the patients treated
surgically showed any postoperative complication or recurrence of the
tuberculosis. These surgical results for endobronchial tuberculosis in
dicate the need for early detection and operation. Bronchoscopy and co
mputed tomography are the methods of choice for accurate diagnosis of
bronchial involvement and assessment of the surgical indications. It i
s emphasized that bronchoplastic surgery is the best treatment for bro
nchial stricture involving bilateral main bronchi.