Abstract
Introduction: With introduction of tuberculostatic drugs, the surgical indications were diminished in the last decades. Altrough, in a country like Romania which touch record level of the tuberculosis's incidence in time, the surgical approach changed. For example, toracoplasty was abandoned or utilized for selected case. Also, there are new methods of diagnosis who require the surgical approach.
Ojectives: The work presents the value of surgery in the diagnosis and in the traitement.
Material and methods: We retrospectively reviewed 67 patients (47 males and 20 females, mean age: 50.2 years) treated between 2008 and 2010. We utilised in diagnosis the mediastinoscopy for mediastinal adenopathies biopsy in 2 cases, videoassisted thoracoscopy for pleural biopsy in 28 cases. We aplied pleuropulmonary decortication for 12 patients with lung trapped after adequate medical therapy.A point of view of lung resection we had 8 atipical lung resection for solitary nodule of unknown cause, 11 lobectomy and 6 pneumonectomy for lung distruction, caverns or MDR-TB.
Results: There was one operation-related death (1.5%) and 5 major postoperative complications (7.5%). 22 of 25 of pulmonary resection remained free of TB folowing surgery. Preoperative comorbidity, Aspergillus coinfection, operation time and emergency were the factors shown to be predictive of an unfavorable outcome.
Conclusions: Surgery remains a crucial adjunct to medical therapy for the treatment of TB and medical failure lesions. We identified temporal changes in the methods of diagnosis and traitement for tuberculosis.
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