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

被引:21
作者
Furák, J
Troján, I
Szöke, T
Tiszlavicz, L
Morvay, Z
Csada, E
Balogh, A
机构
[1] Univ Szeged, Div Thorac Surg, Fac Med, A Szent Gyorgyi Ctr Med & Pharm, H-6720 Szeged, Hungary
[2] Univ Szeged, Div Pathol, Fac Med, A Szent Gyorgyi Ctr Med & Pharm, H-6720 Szeged, Hungary
[3] Univ Szeged, Div Radiol, Fac Med, A Szent Gyorgyi Ctr Med & Pharm, H-6720 Szeged, Hungary
[4] Univ Szeged, Div Pulm, Fac Med, A Szent Gyorgyi Ctr Med & Pharm, H-6720 Szeged, Hungary
关键词
pulmonary tuberculosis; preoperative antituberculotic treatment; diagnostic resection; endobronchial tuberculosis;
D O I
10.1016/S1010-7940(01)00874-0
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
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 pneurnothorax was 11.25 and 4.6%, respectively. The incidence of bronchopleural fistula was 1.25 and 0%, the mortality was 0 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. (C) 2001 Elsevier Science B.V. All rights reserved.
引用
收藏
页码:722 / 727
页数:6
相关论文
共 25 条
[1]   Clinical spectrum of pulmonary and pleural tuberculosis: A report of 5,480 cases [J].
Aktogu, S ;
Yorgancioglu, A ;
Cirak, K ;
Kose, T ;
Dereli, SM .
EUROPEAN RESPIRATORY JOURNAL, 1996, 9 (10) :2031-2035
[2]  
ASHAMURA H, 1992, J THORAC CARDIOVASC, V104, P1456
[3]   UNILATERAL POSTTUBERCULOUS LUNG DESTRUCTION - THE LEFT BRONCHUS SYNDROME [J].
ASHOUR, M ;
PANDYA, L ;
MEZRAQJI, A ;
QUTASHAT, W ;
DESOUKI, M ;
ALSHARIF, N ;
ALJABOORI, A ;
MARIE, A .
THORAX, 1990, 45 (03) :210-212
[4]   Surgical treatment of pulmonary aspergilloma: Current outcome [J].
Babatasi, G ;
Massetti, M ;
Chapelier, A ;
Fadel, E ;
Macchiarini, P ;
Khayat, A ;
Dartevelle, P .
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 2000, 119 (05) :906-912
[5]   ELECTIVE PNEUMONECTOMY FOR BENIGN LUNG-DISEASE - MODERN-DAY MORTALITY AND MORBIDITY [J].
CONLAN, AA ;
LUKANICH, JM ;
SHUTZ, J ;
HUURVITZ, SS .
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 1995, 110 (04) :1118-1124
[6]   WHITHER SHORT-COURSE CHEMOTHERAPY [J].
FOX, W .
BRITISH JOURNAL OF DISEASES OF THE CHEST, 1981, 75 (04) :331-357
[7]   THE EMERGENCE OF DRUG-RESISTANT TUBERCULOSIS IN NEW-YORK-CITY [J].
FRIEDEN, TR ;
STERLING, T ;
PABLOSMENDEZ, A ;
KILBURN, JO ;
CAUTHEN, GM ;
DOOLEY, SW .
NEW ENGLAND JOURNAL OF MEDICINE, 1993, 328 (08) :521-526
[8]   TREATMENT OF 171 PATIENTS WITH PULMONARY TUBERCULOSIS RESISTANT TO ISONIAZID AND RIFAMPIN [J].
GOBLE, M ;
ISEMAN, MD ;
MADSEN, LA ;
WAITE, D ;
ACKERSON, L ;
HORSBURGH, CR .
NEW ENGLAND JOURNAL OF MEDICINE, 1993, 328 (08) :527-532
[9]   SURGICAL INTERVENTION IN THE TREATMENT OF PULMONARY-DISEASE CAUSED BY DRUG-RESISTANT MYCOBACTERIUM-TUBERCULOSIS [J].
ISEMAN, MD ;
MADSEN, L ;
GOBLE, M ;
POMERANTZ, M .
AMERICAN REVIEW OF RESPIRATORY DISEASE, 1990, 141 (03) :623-625
[10]   Bronchoplasty for malignant and benign conditions: a retrospective study of 44 cases [J].
Jalal, A ;
Jeyasingham, K .
EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY, 2000, 17 (04) :370-376