[Repeated operations on the lungs and pleura in tuberculosis]

Reoperations were performed on 71 patients for tuberculosis of the lungs and pleura at the Phthisiosurgical Department of the Kostroma Regional Antituberculotic Clinic from 1971 to 1990. A total of 159 operative interventions were carried out. Among the indications for repeated operations were complications in the early postoperative period, recurrence, reactivation, and progress of the tuberculous process in the lung which had been operated on, tuberculous empyema of the pleura with a bronchopleural fistula, empyema of the residual pleural cavity and a bronchial fistula forming in the late-term periods after the first operation. Operative interventions were undertaken for the second time for tuberculosis of the lung on which the first operation was conducted in chronic abscess. Finally, operations were repeated for other reasons (excision of a ligature fistula, resection of the ribs for osteomyelitis, etc.). Reoperations on 23 patients who had undergone surgery for recurrence or exacerbation of a tuberculous process in the lung consisted in removal of areas of pulmonary tissue remaining after the first operation, they were of the type of pulmonectomy. This is a technically difficult intervention due to the presence of marked cicatricial adhesions in the pleural cavity and changed topography of the thoracic organs and tissues of the thoracic wall. The results of the reoperations were good.