[Surgical treatment of patients with disseminated and progressing pulmonary tuberculosis]. / Khirurgicheskoe lechenie bolnykh s rasprostranënnym i progressiruiushchim tuberkulëzom lëgkikh.

The results of surgical treatment have been summarized for 97 patients with disseminated progressive and complicated tuberculosis associated with respiratory disorders. Of them, 89 (91.8%) had fibrous-cavernous disease and empyema, 72.2% exhibited bilateral advanced process. Noticeable disturbances of ventilation capacity were registered in 47 patients, grave ones in 22 cases. Restrictive and obstructive types predominated. External respiration was impaired most seriously when the process was disseminated and progressive. Respiratory failure increased with growing rates of the disease progression. Pulmonectomy was performed in 58, primary and staged trans-sternal transpericardial occlusions of the main bronchi in 25 cases. The effect was reached in 83.5%, 16.5% of patients died. Lethal outcomes occurred due to bronchopleural complications in 43.8%, pulmonary artery thromboembolism in 18.7% of surgical cases. It is inferred that pulmonary dysfunction cannot be a principal criterion for rejecting operative treatment in progressive and complicated pulmonary tuberculosis.

[New surgical tactics in the treatment of patients with complicated tuberculosis of the lungs and pleura]. / Novaia khirurgicheskaia taktika pri lechenii bol'nykh s oslozhnennym tuberkulezom legkikh i plevry.

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.