RESUMO
The results of surgical treatment were analyzed in 31 patients with complicated abdominal tuberculosis in 2001 to 2003. Before 2003, a surgical intervention was mainly palliative and reduced to the suturing of perforative tuberculous ulcers limited to the resections of the small intestine and to the separation of adhesions (Group 1, n=17). Then radical surgical interventions were undertaken in the volume of extended right-sided hemicolectomies, by removing caseously changed mesenteric lymph nodes (Group 2, n=14). Postoperative peritoneal lavage was performed, by using antituberculous agents. Twelve and 5 patients died in Groups 1 and 2, respectively. The authors suggest that radical surgical interventions for complicated abdominal tuberculosis can improve the outcomes of treatment of this disease.
Assuntos
Tuberculose Gastrointestinal/cirurgia , Antituberculosos/uso terapêutico , Colectomia , Hemorragia Gastrointestinal/etiologia , Humanos , Fístula Intestinal/etiologia , Obstrução Intestinal/etiologia , Perfuração Intestinal/etiologia , Excisão de Linfonodo , Cuidados Paliativos , Lavagem Peritoneal , Peritonite/etiologia , Cuidados Pós-Operatórios , Resultado do Tratamento , Tuberculose Gastrointestinal/complicações , Tuberculose Gastrointestinal/mortalidadeRESUMO
Results of surgical treatment of 31 patients with complicated forms of abdominal tuberculosis treated in 2001-2003 were analyzed. Before 2003 surgery was mainly palliative and managed by suturing of perforated ulcers or economic resection of the small intestine (group 1--17 patients) was made. Since 2003 radical right-sided hemi-colectomies with removal of caseous mesenterial lymph nodes is used (group 2--14 patients). Peritoneal lavage with antituberculosis drugs was performed after surgery. From 17 patients of group 1--12 died, from 14 patients of group 2--5. It is concluded that radical surgery in complicated forms of abdominal tuberculosis permits to improve results of surgical treatment of this disease.
Assuntos
Procedimentos Cirúrgicos do Sistema Digestório/métodos , Intestino Delgado/cirurgia , Tuberculose Gastrointestinal/cirurgia , Úlcera/cirurgia , Antituberculosos/administração & dosagem , Humanos , Perfuração Intestinal/etiologia , Perfuração Intestinal/cirurgia , Cuidados Intraoperatórios , Excisão de Linfonodo , Mesentério , Lavagem Peritoneal , Peritonite Tuberculosa/tratamento farmacológico , Peritonite Tuberculosa/etiologia , Peritonite Tuberculosa/cirurgia , Estudos Retrospectivos , Ruptura Espontânea , Resultado do Tratamento , Tuberculose Gastrointestinal/complicações , Tuberculose Gastrointestinal/tratamento farmacológico , Úlcera/complicações , Úlcera/tratamento farmacológicoRESUMO
The results of the study on the composition, properties and antibiotic sensitivity of pathogenic microbes isolated from purulent wounds of the soft tissues of patients treated in the Institute clinic in 1977-1980 are presented. The frequency of secondary infection of the purulent wounds was estimated. During this period the percentage of gram-negative bacteria isolated from opened purulent foci increased. In some cases investigation of the time course of the purulent processes revealed new microbial strains, such as pathogenic staphylococci or opportunistic gram-negative bacteria. Sometimes replacement of the causative agent by new organisms was observed. The new strains were high- and multiple-resistant to the antibiotics.
