Surgical treatment of first-found destructive pulmonary tuberculosis
Аннотация
Resection operations were performed in 261 patients (males – 155, females - 106) with first-found destructive tuberculosis after 3-6 month long ineffective chemo-therapeutic treatment. The majority of patients (220 – 84.3%) were in young age – from 20 to 40 years old. After a course of chemotherapy, infiltrative tuberculosis with lysis was diagnosed in 12 patients (4.5%), tuberculoma – in 101 (38.7%), fibrous-cavernous – in 148 (56.8%). Mycobacteria of tuberculosis in sputum were observed in 98 patients (37.5%). Segmental lung resection was performed in 112 patients (43.0%) enucleation of tuberculoma – in 13 (5.0%), lobectomy – in 100 (38.3%), combined resection – in 8 (3.0%), and pulmonectomy – in 27 (10.7%). After operation, bronchial fistula and pleural empyema developed in 8 patients (3.1%), early re-activation of the tubercular process – in 10 (3.8%), pneumonia of the operated lung – in 5 (1.9%). These complications in 5 patients were eliminated by therapeutic treatment, in 9 – by repeated operations. A total of 3 patients died from re-activation of tuberculosis, bronchial fistula and pleural empyema. Conclusion. At first-found destructive pulmonary tuberculosis after ineffective chemotherapy course, sparing resection operations are the final stage of complex therapy with low frequency of post-operative complications and high effectiveness of surgical treatment (96.5%).