TY - JOUR T1 - Surgical treatment of first found pulmonary tuberculosis at ineffectiveness of DOTS therapy JF - European Respiratory Journal JO - Eur Respir J VL - 38 IS - Suppl 55 SP - p2685 AU - Tulkun Kariev AU - Sunnatilla Abulkasimov AU - Akram Irgashev Y1 - 2011/09/01 UR - http://erj.ersjournals.com/content/38/Suppl_55/p2685.abstract N2 - Surgeries were performed in 43 patients (males-27, females-22) in ages between 18-53 years old. All the patients had first found destructive tuberculosis of lungs, and ineffectiveness of DOTS therapy was stated in them. During 2-3 months, 23 patients received chemotherapy in hospital (izoniazid, rifampycin, pyrazinamide, ethambutol or streptomycin) and ambulant therapy (izoniazid and rifampycin) under the 1st category of DOTS during 4-6 months.After diagnosing pulmonary tuberculosis, the treatment according to the 1st DOTS category (intensive phase-2-3 months, supporting phase 4-6 months) was received by 20 patients in the first phase. Because of ineffectiveness of chemotherapy, the treatment was continued under the 2nd DOTS category intensive phase chemotherapy with 5 preparations (H, R, Z, E and S) during 3-4 months and ambulant phase (izoniazid, rifampycin, ethambuthol) during 6-8 months. Ineffectiveness of DOTS based chemotherapy-continuing bacteria excretion, presence of pulmonary destruction served as indication to surgical treatment. Segmental pulmonary resection was carried out in 7 patients, lobectomy in 12, pulmonectomy in 24. good clinical effect of performed operations was reached in 40 patients (93.0%). Unsatisfactory results (bronchial fistula and pleural empyema) were stated in 2 patients (4.7%). Lethality in 1 patient (2.3%) was caused by the progress of pulmonary tuberculosis and pleural empyema.Conclusion: When DOTS chemotherapy is ineffective, surgical treatment of first found destructive pulmonary tuberculosis is an important and effective final stage of complex therapy that prevents transition of patients into the group og chronic patients. ER -