Abstract: Objective To summarize and analyze the clinical characteristics, bronchoscopic findings, and clinical efficacy of combined systemic drug therapy and interventional treatment for tracheobronchial tuberculosis (TBTB) with lymph node fistula in children, providing a reference for the clinical diagnosis, treatment, and standardized management of this condition. Method Clinical data of 45 children diagnosed with lymph node fistula type TBTB at Guangzhou Chest Hospital from July 2015 to September 2025 were retrospectively reviewed. General information, clinical manifestations, imaging features, bronchoscopic characteristics, and interventional treatment outcomes were analyzed. Result All 45 pediatric patients were pathologically diagnosed via bronchoscopic biopsy. Among them, 17 were male and 28 were female, ranging in age from 1 to 15 years, with a mean age of (11.24±3.30) years; the duration of illness ranged from 1 week to 1 year. The main clinical manifestations were fever and cough. Imaging studies revealed enlarged hilar or mediastinal lymph nodes, accompanied by pulmonary consolidation or atelectasis. Bronchoscopic classification revealed granulomatous/polypoid type in 30 cases (66.67%) and simple/ulcerative perforation type in 15 cases (33.33%). A total of 90 fistula openings were identified, with multiple lesions being the predominant type; they were mainly distributed in the left and right main bronchi, with a higher prevalence on the right side. The median number of interventional procedures for children with a single lesion (22 cases) was 3.5, while for those with multiple lesions (23 cases) it was 7; the difference between the two groups was statistically significant (P<0.05). The treatment efficacy rate was 100%, and no serious complications occurred either during or after treatment. Conclusion In children with lymph node fistula type TBTB, the bronchoscopic classification is predominantly the granulomatous/polypoid type. Lesions are often multiple and mainly located in the right main bronchus. Systemic anti-tuberculosis drugs combined with bronchoscopic interventional therapy is effective and safe.

Key words: Children, Lymph node fistula, Tracheobronchial tuberculosis, Bronchoscopy, Clinical analysis