THE POSTPONED TREATMENT OUTCOMES IN PULMONARY TUBERCULOSIS PATIENTS AFTER RADICAL PULMONARY RESECTION
https://doi.org/10.21292/2075-1230-2018-96-3-24-28
Abstract
The objective of the study: to investigate the efficiency of surgical treatment in pulmonary tuberculosis patients and to define main risk factors of tuberculosis re-activation in those who had surgery
Methods The postponed surgery results (in 6-7 years) were investigated in 273 patients, who were operated in 2010-2011 Two groups were formed: Group 1 included patients taken off the register due to recovery, Group 2 included patients who had relapse or exacerbation of the disease after the surgery Those taken off the register due to some other reasons were not included in the comparative analysis
Results. It was proved that postponed treatment efficiency exceeded 90% Tuberculosis re-activated in 77% of cases, in those with multiple and extensive drug resistance (533%), lung tissue destruction (62%), fibrous-cavernous tuberculosis (333%), concurrent conditions (524%) and complications in the early post-operative period (95%) The re-activation occurred more often after large surgeries including consecutive corrective thoracoplasty Should there be indications for surgery, it is sensible to decide about the surgery within the 1st year of follow-up.
About the Authors
P. V. Rogozhkin
Samara State Medical University, Samara
Russian Federation
Resident of Phthisiology and Pulmonology Department
Russian Federation
Resident of Phthisiology and Pulmonology Department
E. A. Borodulina
Samara State Medical University, Samara
Russian Federation
Doctor of Medical Sciences, Professor, Head of Phthisiology and Pulmonology Department
Russian Federation
Doctor of Medical Sciences, Professor, Head of Phthisiology and Pulmonology Department
References
1. Vyazkova N.N. Znachenie dinamicheskogo dispansernogo nablyudeniya dlya preduprezhdeniya razvitiya retsidiva tuberkuleza organov dykhaniya iz III gruppy dispansernogo ucheta: Diss. kand. med. nauk. [The value of dynamic dispensary follow-up in prevention of respiratory tuberculosis relapse in the Group III of Dispensary Follow-up. Cand. Diss.]. Moscow, 2008, pp. 28.
2. Garifullin Z.R., Аminev Kh.K. Efficacy of surgical treatment of pulmonary tuberculosis patients with multiple drug resistance depending on the duration of the disease. Tuberculosis and Lung Diseases, 2009, no. 7, pp. 41-46. (In Russ.)
3. Giller D.B., Shaykhaev А.Ya., Vasilieva I.А. Efficiency of partial lung resection of pulmonary tuberculosis patients with multiple drug resistance. Tuberculosis and Lung Diseases, 2008, vol. 85, no. 5, pp. 6-10. (In Russ.)
4. Elkin A.V. Posleoperatsionnye retsidivy tuberkulyoza lyogkikh: faktory riska, khirurgicheskoe lechenie. Diss. dokt. med. nauk. [Post-surgery relapses of pulmonary tuberculosis: risk factors, surgical treatment. Doct. Diss.]. St. Petersburg, 2000.
5. Kvasov Yu.V., Fedorin I.M., Kovtun S.Yu., Kolesnik V.N. History of thoracic surgery in Samara Regional TB Control Services. Tolyattinsky Med. Konsilium, no. 5-6, 2014, pp. 101-104. (In Russ.)
6. Komissarova O.G. Osobennosti techeniya protsessa i effektivnost lecheniya retsidivov tuberkuleza legkikh u bolnykh s razlichnym urovnem generatsii oksida azota v mononuklearakh i neyrophilakh krovi. Diss. kand. med. nauk. [Specifics of the disease progress and treatment efficiency in pulmonary tuberculosis relapses with different level of nitrogen oxide generation in blood mononuclear cells and neutrophiles. Cand. Diss.]. Moscow, 2005,
7. Laptev А.N., Karatysh M.I. Postponed results of early extrapleural thoracoplasty in the integral treatment of pulmonary infiltrate tuberculosis patients with multiple drug resistance. Medistinskaya Panorama, Belorusskiy Gosudarstvenny Meditsinskiy Universitet, Minsk, 2010, no. 9, pp. 14-16. (In Russ.)
8. Lebedeva N.O., Borodulina E.А., Tsygankov I.L., Kovalev S.I., Orlov M.E. TB situation in Samara Region. Izvestiya Samarskogo Тauchnogo Tsentra Rossiyskoy Akademii Nauk, 2012, vol. 14, no. 5 (3), pp. 607-610. (In Russ.)
9. Nekrasov E.V., Yanova G.V. Results of surgical treatment of multiple drug resistant pulmonary tuberculosis patients. Bulleten' VSNTS SO RAMN, 2011, no. 2, pp. 75-77. (In Russ.)
10. Shilova M.V. Tuberkulez v Rossii v 2012-2013 gg. [Tuberculosis in Russia in 2012-2013]. Moscow, 2014, pp. 244.
11. Yablonskiy P.K., Sokolovich E.G., Аvetisyan А.O., Аlkhasov А.B., Аtyukov M.А., Bagdasaryan T.R., Bagirov M.А., Balasanyants G.S. et al. Torakalnaya khirurgiya. Natsionalnye klinicheskie rekomendatsii. [Thoracic surgery. National clinical recommendations]. Moscow, GEOTAR-Media Publ., 2014, 160 p.
12. Man M.A., Nicolau D. Surgical treatment to increase the success rate of multidrug-resistant tuberculosis. Eur. J. Cardio-Thoracic Surgery, 2012, vol. 42, no. 1, pp. 9-12.
13. Orki A. et al. The value of surgical resection in patients with multidrug resistant tuberculosis // Thorac Cardiovasc. Surg. – Vol. 12, № 2. – Р. 157-166.
14. Pomerantz B. J., Cleveland J. C. Jr., Olson H. K. et al. Pulmonary resection for multi drug resistant tuberculosis // J. Thorac. Cardiovasc. Surg. – 2001. – Vol. 121. – Р. 448-545.
15. Shiraishi Y., Nakajima Y., Katsuragi N. et al. Resectional surgery combined with chemotherapy remains the treatment of choice for multidrug resistant tuberculosis // J. Thorac. Cardiovasc. Surg. – 2004. – Vol. 128. – P. 523-528.
16. Wang H., Lin H., Jiang G. Pulmonary resection in the treatment of multidrug resistant tuberculosis: a retrospective study of 56 cases // Ann. Thorac. Surg. – 2008. – Vol. 86. – Р. 1640-1645.
Review
For citations:
Rogozhkin P.V., Borodulina E.A. THE POSTPONED TREATMENT OUTCOMES IN PULMONARY TUBERCULOSIS PATIENTS AFTER RADICAL PULMONARY RESECTION. Tuberculosis and Lung Diseases. 2018;96(3):24-28. (In Russ.) https://doi.org/10.21292/2075-1230-2018-96-3-24-28
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