Abstract:
Introduction: Tuberculosis (TB), an infectious disease caused by
mycobacterial organism and characterized by granuloma formation as a
result of cell mediated immunity, mainly involves the lung. Though
chemotherapy is the mainstay of treatment of TB, surgery is still playing a
major role to treat the patients with complications of TB and multidrug
resistant TB ( MDR-TB). Patients with pulmonary TB (PTB) who underwent
surgical management in our unit are discussed here.
Methods: In 2008 and 2009, a total of 77 patients with 79 operations were
included in the study. These cases were reviewed on age, sex, indication and
type of operation, investigations, pre- and post-operative management and
outcome.
Result: Age ranged from 8 to 55 years, most were females (52%). Destroyed
lung top the list of the indication followed by bronchiectasis, empyema with
non-functioning lung, fibrosis with hemoptysis and destroyed lobe. Pulmonary
resection included pneumonectomy and lobectomy; extended pneumonectomy
and thoracoplasty were performed for combating complications. Major
complications included empyema, reopening for bleeding and bronchopleural
fistula and were observed in 16 patients. Operative mortality was 4 percent.
Seventy one patients recovered from the disease as evidence by no clinical or
radiological sign of disease after one year of operation.
Conclusion: Surgery for PTB is effective and beneficial for the patients who
fail to respond to chemotherapeutic agents alone and those who show
complications of the sequel of PTB.