RESUMO
The outcomes of treatment were analyzed in 108 patients with disseminated and complicated pulmonary tuberculosis. The patient's mean age was 38.3 +/- 4.2 years. Transsternal occlusion of the main bronchus was performed. Concurrently, the following draining interventions were made: thoracostomy, cavernotomy, cavernostomy, or stepwise thoracoplasty. Nine (8.3%) patients intraoperatively died; 20 (18.5%) patients developed recanalization of the main bronchus. Twenty-four (22.2%) patients had a progressive tuberculous process in the contralateral lung. The operation was effective and ensured recovery or stabilization of the tuberculous process in 55 (50.9%) patients. After surgery, dilatation of the pulmonary trunk was 2.8 cm; stroke volume in the pulmonary trunk was 42.4 ml and its distribution along the branches was 83% on the side of the least affection and 17% on that of the greatest affection. At diastole, there was a retrograde blood flow in the branch of the pulmonary artery of the collapsed lung in the volume of 61% of the systolic stroke volume. The calculated pulmonary pressure was 52 mm Hg. Transsternal occlusion of the main bronchus, involving stepwise draining interventions, should be considered the method of choice in treating these patients.
