Recovery process in lung tissue patients with XDR tuberculosis after preoperative intravenous laser blood irradiation

Abstract

Introduction: An important role in treatment of fibro-cavernous XDR tuberculosis is played by the surgical methods.

Aim: The study of the effects of the intravenous laser blood irradiation (IV LBI) on the efficiency of preoperative preparation and surgical treatment of patients with XDR TB.

Methods: We studied 147 patients with fibro-cavernous pulmonary XDR TB. 1 group – 68 patients, who underwent a course of treatment with IV LBI (630 nm). 2 group – 80 patients, who were not treated with IV LBI.

Results: All patients were operated. The patients treated with using IV LBI more often noted resorption of infiltration (17%) and сlosure of the cavities was more frequent (8%). In 1 group the increase of blood circulation around the cavity more often by 32%. Histological examination after surgery showed that in 2 group tuberculosis process has characteristic signs of pronounced progression with predominance of caseous-necrotic and exudative components. In group 1 small pockets of compacted caseous surrounded by a thin layer of granulation tissue and well-formed fibrous capsule. Large caverns have a wide fibrous wall, often with focal infiltration of lymphoid and macrophage elements, the presence of different areas of compacted caseosis, sometimes with calcification. On the periphery of the thick fibrous capsule can be seen glandular structures formed cubic epithelium without signs of atypia and reflecting the regeneration of alveolar tissue in this area. Fresh foci of dissemination and epithelial cell granulomas are not determined or isolated.

Conclusion: The use of VLBI in preoperative preparation promotes healing processes and leads to effective surgical treatment.