Role and Outcome of Surgery for Pulmonary Tuberculosis

Abstract

The need and outcome of surgical intervention in patients with pulmonary tuberculosis were assessed retrospectively. Between 1993 and 2003, 72 major surgical procedures were performed in 57 patients with pulmonary tuberculosis. There were 44 males and 13 females with a mean age of 34 years. Indications for surgery were: trapped lung in 18 (31.6%), multidrug-resistant tuberculosis in 10 (17.5%), aspergilloma in 10 (17.5%), destroyed lung in 5 (8.8%), massive hemoptysis in 4 (7%), bronchopleural fistula in 3 (5.3%), persistent cavity in 2 (3.5%), and undiagnosed nodule in 5 (8.8%) patients. The most common procedure was lobectomy (31.9%). Other procedures included decortication, wedge resection, pneumonectomy, segmentectomy, and myoplasty. There were 28 complications in 18 patients, including prolonged air leak in 12 (21.1%), residual space in 7 (12.3%), empyema in 5 (8.8%), hematoma in 2 (3.5%), chylothorax and bronchopleural fistula in 1 (1.8%) each. There was no operative death, but one patient died from sepsis late in the follow-up period (mortality, 1.8%). As morbidity and mortality rates are acceptable, surgical intervention can be considered safe and effective in patients with pulmonary tuberculosis.

Surgery for pulmonary tuberculosis — a 15-year experience☆

“…Recent published series have demonstrated mortality ranging from 0% to 3.1% [5][6][7][8][9]2]. Mortality rate in our series -1.37% early and 2.83% late -compares quite favourably with these other published series.…”

Surgical treatment of drug-resistant tuberculosis

“…45,60 Other indications for surgical resection not restricted to drug-resistant disease included the following complications of TB: bronchiectasis, empyema, hemoptysis, and aspergilloma. 52,60,62,68 …”

Tuberculosis-Associated Secondary Pneumothorax: A Retrospective Study of 53 Patients

“…8,9 Pneumothorax is one of the important TB complications that requires surgery. [8][9][10][11] Pneumothorax secondary to TB usually occurs after extensive TB involvement of the lung, and the sudden onset of bronchopleural fistulization and empyema 12 with severe cavitary formations or occasionally with miliary TB. The TB organism invades the pleura and causes liquifactive necrosis, then pleural rupture.…”