A role of surgery in sanitation of patients with multiple drugresistant pulmonary tuberculesis

Abstract

Purpose. Elaboration of intensive preoperative specific chemotherapy and determination of surgical treatment efficacy in patients with pulmonary tuberculesis with multiple drug resistance.

Material and methods. As a clinical material for the survey 65 patients with multiple-drug-resistant tuberculesis were selected, who had been operated in the pulmonary-surgical department of the Yakutsk Research Institute of tuberculesis from 2000 to 2003. Treatment efficacy was being determined when observing patients in the course of 2-3 years after the operation.

Results. In 76.6% cases the long-lasting chemotherapy promotes to MDR tuberculesis forming and efficacy of the operation depends direct proportionally on duration of the disease. In 23.1% patients with lower severity of MDR tuberculesis micobacterial tuberculesis (MBT) was a find being detected from the resected lung portion after operation. Surgical treatment efficacy of MDR tuberculesis is estimated at 83.0%, postoperative complications – 10.7%, postoperative activation of tuberculesis – 4.6%, lethality – 6.1%.

Conclusion. Initial patients with prevalent MDR tuberculesis are to be operated on when the phase “treatment prolongation” expires, i.e. in the late 5-6 months of chemotherapy, others with lower severity - in 2-4 months.