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.
