ABSTRACT
Analysis is given of the results of a surgical treatment of 75 patients with cavernous pulmonary tuberculosis that was characterized by the prevalence of pathomorphological features (79%) of the process development. It is shown that signs of chemotherapy inefficiency can be established as early as 4-6 months after the treatment of destructive tuberculosis was begun. The distinguishing features of surgical interventions during this period comprise a small volume of resection, minimal intraoperative blood loss and little time spent on the operation. These interventions have high effectiveness (98.7%) in the absence of fatal outcomes and can be recommended for wide use in the practice of antituberculosis therapeutic institutions.
Subject(s)
Tuberculosis, Pulmonary/surgery , Adolescent , Adult , Evaluation Studies as Topic , Female , Humans , Lung/pathology , Middle Aged , Radiography , Tuberculosis, Pulmonary/diagnostic imaging , Tuberculosis, Pulmonary/pathologyABSTRACT
Stepwise surgical tactics by using transsternal transepicardial preocclusion of the main bronchus and lung root vessels, opening of the empyema cavity and pneumotomy has been proposed to treat patients with progressive fibrocavernous tuberculosis complicated by pneumothorax and pleural empyema and extended into the thoracic wall. After 1.5-2 months the main stage of the operation, pleuropulmonectomy, is performed. Among the 25 patients operated on, the clinical effect was achieved in 15, 5 patients continued to take treatment, 5 patients died. The first results show that active care may be delivered to patients with complicated pulmonary and pleural tuberculosis who have recently had no hope to be recovered and the process be steady.
Subject(s)
Tuberculosis, Pleural/surgery , Tuberculosis, Pulmonary/surgery , Adult , Empyema, Pleural/etiology , Humans , Male , Pneumonectomy , Pneumothorax/etiology , Tuberculosis, Pleural/complications , Tuberculosis, Pulmonary/complicationsABSTRACT
The results of surgical treatment of 550 patients who were subjected to pulmonectomy for tuberculosis (74.7%) and other respiratory diseases (25.3%) were analysed. Pulmonectomy was either used as an emergency procedure or performed after a short-term intensive preparation depending on the severity of the clinical picture and life-threatening syndrome. New surgical tactics consisting of stage-by-stage and combined surgical interventions has been developed and is used in clinical practice. Pulmonectomy which is performed at the stage of the clinical stabilization of the process is the most effective. Despite high surgical risk, pulmonectomy in progressive and complicated tuberculosis provides clinical effectiveness in 76.9-83.7% of patients.
