[Lung resection in drug resistant tuberculosis patients]. / Rezektsiia legkikh u bol'nykh tuberkulezom s lekarstvennoi ustoichivost'iu.

Three and seventy-one case histories of patients operated on for different forms of pulmonary tuberculosis in whom their Mycobacteria tuberculosis (MT) were resistant to bactericidal drugs (BD) were analysed. Fibrocavenous or cavernous pulmonary tuberculosis was detected in most patients (73.3%). Various postoperative complications occurred in 20% of the patients operated on, in them empyema with bronchial fistula was stated in 6.5% of cases. The immediate outcomes of lung resections were satisfactory in 90% of patients and poor (progressive tuberculosis, uncorrected empyema) in 6%, mortality was 4%. Comparing these data with the outcomes of 6033 resections whose efficiency was 96.4% and mortality 1.4% leads to the conclusion that MT resistance to BD negatively affect the outcomes of resections.

[Results of surgical intervention depending on duration of preoperative treatment of pulmonary tuberculosis patients]. / Rezul'taty khirurgicheskogo vmeshatel'stva v zavisimosti ot prodolzhitel'nosti dooperatsionnogo lecheniia bol'nykh tuberkulezom legkikh.

The case histories of 428 patients operated on for tuberculosis were analyzed. Three groups were identified. They were as follows: 1) 121 patients untreated with bactericidal drugs before surgery; 2) 247 patients treated less than 6 months before it; 3) 160 patients treated more than 6 months before surgery. Various complications due to resection of the lung were observed in 30 (7%) patients undergone surgery. They were 6.6, 6.8, and 7.5% in Groups 1, 2, and 3, respectively. A clinical effect was achieved in 99.8% of cases. The late outcomes of surgical intervention were studied within 1 to 10 years in 354 patients, including 102, 119, and 133 patients in Groups 1, 2, and 3, respectively. Progressive and recurrent tuberculosis was revealed in 7 (6.8%), 11 (9.2%), and 18 (13.5%), respectively. Thus, immediate and late outcomes of surgical treatment were not worse in patients with tuberculomas untreated with bactericidal drugs before surgery than in those who receive long-term therapy that substantially reduces the duration of therapy, which is a most important task of modern phthisiology. So patients should be operated on when they are found to have pulmonary tuberculomas without signs of a progressive tuberculous process.