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[Delayed complications after extrapleural pneumonolysis for lung tuberculosis]
A Stobernack1, R Achatzy, C Engelmann
1Abteilung für Thorax- und Gefässchirurgie, Lungenklinik Hemer.
Der Chirurg; Zeitschrift Fur Alle Gebiete Der Operativen Medizen
|December 31, 1997
Summary
Surgical plombage, used to treat tuberculosis after WWII, led to late-onset infections and neoplasms. Removal of this filling material is recommended, especially when associated with lymphoma, due to potential carcinogenicity.
Area of Science:
- Thoracic surgery
- Pulmonology
- Oncology
Background:
- Tuberculosis treatment post-WWII saw a resurgence in surgical interventions like plombage thoracoplasty.
- Paraffin and polyethylene were used for extrapleural pneumothorax to collapse lung cavities.
- Early complications and suspected carcinogenicity led to material removal in many cases.
Observation:
- 13 patients underwent removal of plombage material between 1985-1996 due to complications.
- Complications included infections (11 patients), lymphoma (1), and bronchial carcinoma (1).
- Procedures involved various thoracoplasty techniques, muscle flap repair, thoracic wall resection, empyemectomy, and pleuropneumonectomy.
Findings:
- Late complications (30-40 years post-implantation) included infections and neoplasms.
- Malignant lymphoma was associated with plombage infection, suggesting potential carcinogenicity.
- Two procedure-related deaths occurred (pulmonary embolism, pneumonia with multi-organ failure).
Implications:
- Removal of plombage material is crucial for patients experiencing late complications.
- The material may be carcinogenic, particularly in cases of lymphoma, necessitating timely removal.
- Further research into long-term effects and safer alternatives for tuberculosis management is warranted.