POSTPONES OUTCOMES OF RESECTION AND COLLAPSE SURGICAL INTERVENTIONS FOR PULMONARY TUBERCULOSIS

Abstract

A retrospective cohort study of postponed outcomes of surgical treatment of patients with pulmonary tuberculosis was conducted; all patients lived in the region with a high prevalence of the disease (the Republic of Altai) and were treated during the period from 2004 to 2014. All patients (n = 215) had indications for surgical treatment. The main group included 111 patients who underwent surgery further on, while the comparison group included 104 patients who rejected the proposed surgery for various reasons. Outcomes were analyzed in 3-9 years after indications for surgical treatment were identified, depending on the clinical form of tuberculosis and type of surgical intervention. It was found that the lung resection as a part of the comprehensive treatment of patients with pulmonary tuberculomas allowed achieving clinical cure in a confidently bigger number of cases (97.1%) compared to those who rejected surgical treatment (80.0%, p = 0.003; χ2). Clinical cure after resections due to fibrous cavernous tuberculosis was achieved in 90.0% of patients, and only in 44.4% of those who refused surgical treatment (p = 0.02; two-sided Fischer’s Exact test). Collapse surgery allowed achieving clinical cure in 62.5% of cases with disseminated fibrous cavernous pulmonary tuberculosis, while conservative treatment provided clinical cure only in 8.6% of cases (p = 0.0001; two sided Fischer’s Exact test); the mortality made 6.3 and 42.8%, respectively (p = 0.01; two-sided Fischer’s Exact test).