RT Journal Article
SR Electronic
T1 New approaches to surgical treatment of patients with tuberculosis of lungs revealed for the first time in combination with diabetes mellitus
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P2407
VO 40
IS Suppl 56
A1 Yaroslav Voloshyn
YR 2012
UL http://erj.ersjournals.com/content/40/Suppl_56/P2407.abstract
AB 257 patients with destructive tuberculosis of lungs and diabetes operated in the Institute (last 25 years). Men - 148 (57,58%), women - 109 (42,41%), aged 14-67 years. Insulin-dependent diabetes - 199 (77,43%), insulin-independent - 58 (22,57%): severe form - 174 (67,7%), moderate - 62 (24,13%), light - 21 (8,17%).Before reaching the Institute - chemotherapy (6 months) - 95 (36,96%), 6-12 months - 150 (58,37%), none - 12 (4,67%). Indications to operation: tuberculoma - 125 (48,64%), fibrocavernous tuberculosis - 109 (42,41%), cavernous - 5 (1,95%), disseminated - 4 (1,56%), caseous pneumonia - 14 (5,45%).New methods of preoperative preparation, operative and postoperative treatment (using erbisol and other new preparations) worked out.Segmentectomy - 188 (73,15%), lobectomy - 59 (22,96%), bilobectomy - 7 (2,72%), combinated resection - 20 (7,78%), pneumonectomy - 19 (7,39%), precising resection - 25 (9,73%), new methods of cryosurgery, videothoracoscopy, including biological welding of tissues.Complications - 27 (10,51%), lethality - 5 (1,95%), clinical effect - 252 (98,05%). After discharging from the Institute chemotherapy - 7-12 months on the background of dietinsulintherapy, treatment against relapse - spring and autumn (3 years). Full clinic effect (1-18 years) - 92,5%.So, taking into consideration particular features of tuberculosis course, mutual complication of both diseases, experience of many years, high efficiency of complex treatment let work out the indications to resection of lungs in cases of tuberculosis with diabetes. New methods of treatment were worked out and new technologies of operation were introduced.