TY - JOUR T1 - The role of extrapleural thoracomyoplasty for conversion of smears in patients with drug resistant destructive pulmonary tuberculosis JF - European Respiratory Journal JO - Eur Respir J VL - 44 IS - Suppl 58 SP - P2436 AU - Grigorii Kudriashov AU - Armen Avetisyan AU - Igor Vasiliev AU - Galina Marfina AU - Evgeniya Popova AU - Nataliya Blum AU - Evgenii Sokolovich AU - Peter Yablonsky Y1 - 2014/09/01 UR - http://erj.ersjournals.com/content/44/Suppl_58/P2436.abstract N2 - Introduction: drug resistant (DR) destructive pulmonary tuberculosis (TB), progressive for a long time, is an indication the drugs are stopped (WHO, Guidelines for the programmatic management of DR TB, 2007). The role of surgical treatment for these patients is unclear. Aim: To determine the feasibility of thoracomyoplasty for treatment of patients with DR destructive pulmonary TB. Methods: prospective clinical trial during 2013 year. 18 consecutive patients (3 female, 15 male) with destructive pulmonary TB. 1st group (gr.) - 5 patients with two-sided tuberculosis lung destruction; 2nd gr. - 13 patients with one-sided cavities in lung. All patients had a progressive of pulmonary TB (XDR-TB in 10 cases, MDR-TB in 8 cases) despite of the long time chemotherapy according to DST of MTB (more than 12 months) and positive smear on MTB before admission in clinic. Charlson comorbidity index was 1+0.57 in 1st gr., 1.2+0.63 in 2nd gr. All patients had respiratory insufficiency (MRC 2-3, FEV 1 <50%) and malnutrition. All patients were underwent extrapleural thoracomyoplasty (in 3 cases was performed consecutive two-sided thoracomyoplasty). Results: Postoperative period was uncomplicated in 14 cases. In 3 cases were seroma in postoperative scar. In 1 case was postoperative progression of TB. Middle operative time was 126+17 min. Operation hemorrhage was 138+65 ml. Rate of conversion of smears in 1st gr. was 40%, in 2nd gr. – 57%. Conclusion: thoracomyoplasty for treatment patients with progressive DR destructive pulmonary TB accompanied with good rate of conversion in early postoperative period, acceptable morbidity and absence of mortality. ER -