Pulmonale Tuberkulose – ist die Chirurgie noch notwendig?

Klotz, Laura V.; Lindner, Michael; Hatz, Rudolf

doi:10.1055/s-0035-1546249

Zentralbl Chir

2015

DOI: 10.1055/s-0035-1546249

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Pulmonale Tuberkulose – ist die Chirurgie noch notwendig?

Laura V. Klotz

Michael Lindner

Rudolf Hatz

Abstract: The indication for surgery should always be made in a multimodal therapeutic approach by an interdisciplinary team, taking patient age and functional analysis into account. Effective antibiotic therapy should be performed before and after surgery in order to achieve a sustained treatment success.

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Cited by 3 publications

References 33 publications

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Surgical treatment of pulmonary tuberculosis in children

Опанасенко¹,

Tereshkovych²,

Shamray³

et al. 2019

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Objective. To estimate the results of surgical treatment in children, suffering pulmonary tuberculosis. Materials and methods. The results of surgical treatment of 83 children, suffering pulmonary tuberculosis in Jan. 2008 - June 2019 yrs are presented. Immediate and late results of performance of various operative interventions, rate of tuberculosis recurrence and postoperative morbidity are presented. Results. Efficacy of operative treatment (arrest of bacterioleak, improvement of clinical state, closure of the destruction cavity, positive roentgenological dynamics) in terms of observation up to10 yrs was observed in 81 (97.6%) patients. Postoperative complications were developed in 11 (13.3%) patients, they have healed conservatively. Tuberculosis recurrence in postoperative period have occurred in (2.4%) patients. Conclusion. It is possible to enhance the efficacy of treatment in children, suffering pulmonary tuberculosis, using various operative procedures. While selecting the method for surgical treatment of pulmonary tuberculosis in children, the advantage must be given to anatomic resection. Lobectomy constitutes the optimal variant of the operation. During performance of resection in children, in patients with multiresistant tuberculosis or tuberculosis with extended medicinal resistance, for prevention of pulmonary overstretching it is mandatory to apply the methods for the hemithorax volume correction (pneumoperitoneum, phrenicotripsy or one of thoracoplasty procedures).

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Surgical treatment of pulmonary tuberculosis in children

Опанасенко¹,

Tereshkovych²,

Shamray³

et al. 2019

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Persons working capacity after pulmonary tuberculosissurgery

Duzhyi¹,

Kravets²,

Dmytruk³

et al. 2018

Tuberculosis, Lung Diseases, HIV Infection

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Video-Assisted Resections for Pulmonary Tuberculosis With the Presence of Pleural Cavity Obliteration

Опанасенко¹,

Лысенко²,

Tereshkovych³

et al. 2021

UPJ

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Pulmonary tuberculosis surgery is characterized by a number of aspects associated with adhesions in the pleural cavity, fibrosis of the lung root, destruction of the parenchyma, which contribute to the development of intra- and postoperative complications such as residual pleural cavity and reactivation of tuberculosis in operated lung due to compensatory tissue distortion. Aim: to improve video-assisted lung resection (VATS) in tuberculosis patients with the presence of pleural cavity obliteration. Materials and methods. The developed method of VATS for tuberculosis patients with pleural cavity obliteration is based on separate intubation of right and left main bronchi for mechanical ventilation of one lung, placement of thoracic port, performing revision of pleural cavity using video-assisted thoracoscopy, performing mini-thoracotomy and resection of lung with separate treatment of anatomical structures in required volume by means of disposable stapler or regular open thoracotomy instruments, pleural cavity draining and layered wound closure. Computed tomography of chest is performed during the operation in order to assess the extent and severity of pleural adhesions and to locate safe position of thoracic ports. Hydraulic needle preparation of parietal pleura is performed in severe adhesions area. Hemorrhage is treated using hemostatic plate Surgicel Fibrillar made of restored cellulose. Phrenicotripsy, pleural cavity drainage and, finally, artificial pneumoperitoneum are performed. The proposed method of video-assisted lung resection was used in 41 patients, 25 patients underwent video-assisted resection according to the prototype method. Results. The proposed method reduced duration of the surgical intervention by 52.7 minutes; the frequency of intraoperative complications by 14.4%; the incidence of postoperative complications by 14.2; the duration of patient�s stay at the hospital by 5.8 days and increased of overall treatment efficiency by 14.5%. The proposed method of VATS for patients with pulmonary tuberculosis and pleural cavity obliteration is safe, effective, simple to implement and can be performed at thoracic surgery departments of various pulmonary hospitals of city and regional level. Key words: pulmo

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Pulmonale Tuberkulose – ist die Chirurgie noch notwendig?

Cited by 3 publications

References 33 publications

Surgical treatment of pulmonary tuberculosis in children

Surgical treatment of pulmonary tuberculosis in children

Persons working capacity after pulmonary tuberculosissurgery

Video-Assisted Resections for Pulmonary Tuberculosis With the Presence of Pleural Cavity Obliteration

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