Abstract
Background: Effectiveness of surgical treatment of patients with multiple TB-affected sites – tuberculomas with cavities complicated by TB empyema and TB spondylodiscitis of the thoracic spine – is achieved by single-stage surgical interventions into the lungs, pleura and vertebras, which provides positive outcomes in TB treatment.
Aim: To develop and improve surgical approaches and methods of single-stage interventions into the lungs, pleura and vertebras based on the modern methods of radiological and radioisotopic diagnostics.
Methods: We studied and operated on 6 patients with multiple TB-affected sites: 4 patients with simultaneous TB empyema and TB spondylodiscitis of the thoracic vertebras, 2 patients with cavitary tuberculomas and spondylodiscitis.
In the pre-operative period the patients underwent contrast MR-scan, 3D MSCT, scintiscanning of the lungs and the thoracic spine; we developed individual surgical treatment and surgical approach plans for each patient considering the localization and the affected side on the lungs.
Results: All the six patients underwent surgery. 4 patients underwent total pleurectomy, 2 – combined S1-S2 and S4 resection with simultaneous resection of thoracic vertebral bodies with anterior lateral spinal fusion using autotransplantation from a rib and osteoset vertebroplasty.
Conclusion: Single-stage surgical interventions into the lungs, pleura and thoracic vertebras allow radical removal of pathological TB foci, which leads to declining intoxication symptoms, more rapid stabilization of TB process and preserved working capacity.
- Copyright ©the authors 2016