Surgical intervention for pulmonary tuberculosis: Analysis of indications and perioperative data relating to diagnostic and therapeutic resections

József Furák, Imre Troján, Tamás Szöke, László Tiszlavicz, Zita Morvay, Edit Csada, Ádám Balogh

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25 Citations (Scopus)

Abstract

Objective: To analyze the data on patients operated on for pulmonary tuberculosis (TB) with (Group I) or without (Group II) a correct TB diagnosis and preoperative anti-TB treatment. Methods: Between 1980 and 1997, 144 resections for TB (Groups I + II) were performed. The 80 patients in Group I underwent therapeutic resections: 32 cases involved recurrent cavities or tuberculomas, three involved post-TB bronchiectasis, 13 involved progression of cavities or tuberculomas, and 32 involved persistent tuberculomas after 6 months of anti-TB therapy. The 64 patients in Group II were operated on for a suspicion of malignancy in 49 cases, for cavitary lesions with haemophthysis in six cases, for multiple lesions in seven cases, and for recurrent hydrothorax in two cases. Results: Groups I and II included 0 and five pneumonectomies, 32 and 29 lobectomies, 48 and 20 wedge resections, 0 and nine videothoracoscopic biopsies, and 0 and one hilar lymphadenectomy, respectively. In Groups I and II, the mean duration of postoperative hospitalization was 13.2 and 10.4 days, and the frequency of postoperative pneumothorax was 11.25 and 4.6%, respectively. The incidence of bronchopleural fistula was 1.25 and 0%, the mortality was O and 3.1%, and the morbidity was 53.7 and 35.9% in Groups I and II, respectively. Two patients with active disease died in Group II. Pathology demonstrated that the frequency of acid-fast bacilli in Groups I and II was 40 and 25%, respectively. Conclusions: Patients without a correct preoperative TB diagnosis underwent more extensive parenchyma resection. Postoperative complications increased when acid-fast bacilli were present. The lack of preoperative anti-TB treatment did not involve a higher risk of minor complications, but death occurred only in this group.

Original languageEnglish
Pages (from-to)722-727
Number of pages6
JournalEuropean Journal of Cardio-Thoracic Surgery
Volume20
Issue number4
DOIs
Publication statusPublished - Jan 1 2001

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Keywords

  • Diagnostic resection
  • Endobronchial tuberculosis
  • Preoperative antituberculotic treatment
  • Pulmonary tuberculosis

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

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