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Modern morbidity following pulmonary resection for postprimary tuberculosis
A Rizzi1, G Rocco, M Robustellini
1Division of Thoracic Surgery, E. Morelli Regional Hospital, Sondalo (Sondrio), Italy.
World Journal of Surgery
|June 1, 1997
Summary
Surgical resection is a valuable treatment for advanced postprimary tuberculosis, offering a 93% healing rate with no operative mortality. This approach is effective for disease progression, drug resistance, and complications, requiring careful patient selection and management.
Area of Science:
- Thoracic Surgery
- Infectious Diseases
- Pulmonary Medicine
Background:
- Postprimary tuberculosis often necessitates surgical intervention due to disease progression, multidrug resistance, or treatment noncompliance.
- Surgical management is considered for sequelae, suspected malignancy, and complications like bronchopleural fistula and empyema.
Purpose of the Study:
- To evaluate the therapeutic value and outcomes of surgical resection in patients with postprimary tuberculosis.
- To identify indications, common procedures, complications, and success rates of surgical treatment for this condition.
Main Methods:
- A retrospective review of 28 patients with postprimary tuberculosis who underwent surgical resection between January 1991 and March 1996.
- Procedures included upper lobectomy, segmental resections, bilobectomy, and completion pneumonectomy, with detailed analysis of operative indications and complications.
Main Results:
- The most common indications were multidrug resistance (11/28) and disease progression (8/28).
- Upper lobectomy was the most frequent procedure (16/28), with a 93% healing rate (26/28) and no operative mortality.
- Major complications included recurrent disease (7%) and pulmonary embolism (3.5%); minor morbidities involved air leaks (18%) and wound breakdown (14%).
Conclusions:
- Surgical treatment of postprimary tuberculosis is effective when indicated correctly, supported by appropriate medical management, and executed with meticulous technique.
- The study confirms the therapeutic value of resection in managing complex cases of postprimary tuberculosis, achieving high healing rates and low mortality.