[Multidrug-resistance: the modern problem of surgical treatment of pulmonary tuberculosis]

The problem of multidrug-resistance is urgent because the part of these patients undergoes treatment failure after chemotherapy. In such cases the operations are performed. In 1998-2002 in the Department of Thoracic Surgery of Republic Santariskes Tuberculosis and Lung Disease Hospital 739 thoracic operations were performed for the patients with pulmonary tuberculosis. Because of multidrug-resistant pulmonary tuberculosis 355 patients (48%) were operated on, radical operations were performed to 190 patients (53.5%) and for 165 (46.5%) - palliative. Positive outcome was documented for 324 patients (91.3%); 31 patients (8.7%) died. Various postoperative complications were confirmed in 76 cases (21.4%) when multidrug-resistance was determined. CONCLUSIONS. When multidrug-resistance is developed, clinic or radiological dynamics of tuberculosis process is not positive, after 3-4 months is it necessary to discuss the question of the operation. In case of monolateral process the radical operations with the type of resection are performed, but in case of widespread process and various complications palliative operations are performed. The treatment with antituberculotic drugs when patient is operated on because multidrug-resistance is continued for 22-24 months.