[Surgical treatment of patients with disseminated and progressing pulmonary tuberculosis]

The results of surgical treatment have been summarized for 97 patients with disseminated progressive and complicated tuberculosis associated with respiratory disorders. Of them, 89 (91.8%) had fibrous-cavernous disease and empyema, 72.2% exhibited bilateral advanced process. Noticeable disturbances of ventilation capacity were registered in 47 patients, grave ones in 22 cases. Restrictive and obstructive types predominated. External respiration was impaired most seriously when the process was disseminated and progressive. Respiratory failure increased with growing rates of the disease progression. Pulmonectomy was performed in 58, primary and staged trans-sternal transpericardial occlusions of the main bronchi in 25 cases. The effect was reached in 83.5%, 16.5% of patients died. Lethal outcomes occurred due to bronchopleural complications in 43.8%, pulmonary artery thromboembolism in 18.7% of surgical cases. It is inferred that pulmonary dysfunction cannot be a principal criterion for rejecting operative treatment in progressive and complicated pulmonary tuberculosis.