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Pneumonectomy for tuberculosis

M Ashour1

  • 1Division of Thoracic Surgery, King Khalid University Hospital, Riyadh, Saudi Arabia.

European Journal of Cardio-Thoracic Surgery : Official Journal of the European Association for Cardio-Thoracic Surgery
|August 1, 1997
PubMed
Summary
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Pneumonectomy for tuberculosis lung destruction in 20 patients showed no mortality and acceptable morbidity. Meticulous surgical technique is crucial for avoiding complications in tuberculosis surgery.

Area of Science:

  • Thoracic Surgery
  • Infectious Diseases
  • Pulmonary Medicine

Background:

  • Surgery for tuberculosis (TB) poses significant risks, especially pneumonectomy.
  • Post-tuberculosis lung destruction necessitates surgical intervention in some cases.

Purpose of the Study:

  • To evaluate the safety and efficacy of pneumonectomy for treating tuberculosis-induced lung destruction.
  • To assess the morbidity and mortality associated with this procedure.

Main Methods:

  • A retrospective review of 20 patients who underwent pneumonectomy for Mycobacterium tuberculosis between 1985 and 1995.
  • Patients presented with severe lung destruction, cough, and hemoptysis; some had drug resistance or aspergilloma.
  • Preoperative assessment included radiological evidence of unilateral destroyed lung with no perfusion.

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Main Results:

  • No mortality was observed in the 20 patients undergoing pneumonectomy.
  • Morbidity was 15%, with two patients requiring re-exploration for bleeding and one developing empyema.
  • All patients were symptom-free during a mean follow-up of 93.7 months.

Conclusions:

  • Pneumonectomy for tuberculosis and post-tuberculosis lung destruction can be performed with no mortality and acceptable morbidity.
  • Meticulous surgical technique is essential to minimize operative complications.
  • Persistent positive sputum for acid-fast bacilli should not contraindicate surgery in symptomatic patients.