The role of resection surgical techniques in complex treatment of multi-resistant pulmonary tuberculosis

• Published in: Khirurgiia no. 1-2; p. 5
• Main Authors: Petrov, D, Stefanova, D, Goranov, E, Plochev, M, Dzhambazov, V
• Format: Journal Article
• Language: Bulgarian
• Published: Bulgaria 2008
• Subjects: Adolescent; Adult; Aged; Antitubercular Agents - administration & dosage; Antitubercular Agents - pharmacology; Antitubercular Agents - therapeutic use; Drug Resistance, Multiple, Bacterial; Female; Humans; Male; Middle Aged; Pneumonectomy - methods; Pneumonectomy - mortality; Recurrence; Retrospective Studies; Treatment Outcome; Tuberculosis, Pulmonary - diagnosis; Tuberculosis, Pulmonary - drug therapy; Tuberculosis, Pulmonary - mortality; Tuberculosis, Pulmonary - surgery; Young Adult
• ISSN: 0450-2167

A total of 16 patients with pulmonary resections for MDR-TB are included in a retrospective study for a period of 7 years. They are 9 (63.4%) male and 7 (36.3%) female with an average age of 32.6 years. Unilateral cavitary lesions are visualized in all patients. Bilateral changes are found in 9 (55.5%) patients, but the contralateral lesions are predominantly nodules and fibrosis. Multi-drug resistance was observed to an average of 4.4 anti-TB medicines. The mean duration of the preoperative re-treatment regimens is 4.9 months. Despite the preoperative anti-TB treatment, 8 (50%) of our patients are positive at the time of surgery. The following operations are carried out: lobectomy (68.75%), lobectomy with S6 (6.25%) and pneumonectomy (25%). No intraoperative and 30-day postoperative deaths are observed in our cohort. Postoperative complications are found in 4 (25%) of the cases. The mean postoperative in-hospital stay is 10.2 days. The postoperative anti-TB regimens are administered for at least 18 months, but in most of the patients their duration is 24 months. Postoperative follow-up is possible in all patients for the mean period of 34 months. Relapse of the disease is found in 3 (18.75%) preoperatively positive patients. Late mortality is observed in 1 (6.2%) patient 9 months after pneumonectomy due to relapse and empyema development. Eight (50%) of the patients are under follow-up program without medication. The rest 5 (31.25%) patients are negative but still on anti-TB regimens. In conclusion, we feel that pulmonary resections are of a paramount importance as an adjunctive method in the complex treatment of MDR-TB with good postoperative results.