Keywords
Abstract
In the structure of operations used in the treatment of lung tuberculosis, pneumonectomy are one-tenth. We conducted a prospective study. The aim of the study was to increase the effectiveness of surgical treatment of patients with pulmonary tuberculosis depending on the clinical features of the case, the characteristics of the functional state of external respiration, hemodynamics, and the comorbid background. Design of the study: a prospective non-randomized single-centre study. Terms of research: 2015-2016 years. Inclusion criteria: patients with established and verified diagnosis of pulmonary tuberculosis who received at least 4 months of chemotherapy in the absence of bacterial excretion and 6 months in the presence of bacterial excretion, according to drug susceptibility data, over the age of 18 years. Surgery plain was pneumonectomy. Consent of the patient to the inclusion and implementation of the study protocol. Exclusion criteria: diseases that limit the mobility of the chest, the presence of a cavity of destruction in the contralateral lung, refusal of the patient from «cooperation», contraindications to surgical treatment in accordance with clinical recommendations. Material: according to inclusion criteria the study included 39 patients who underwent 39 pneumonectomies. А complete protocol of the survey was performed in 28 (71.8%). Intraoperative complications: associated with adhesiolysis blood loss consisted of 3500 ml, also v. azygos was damaged due to pleural fusion delivering. Intraoperative complications rate was 5,13%. Various factors in postoperative period were analyzed. Complications rate according to R. Korst classification (1998) was 20,5%, according to TM&M classification was 30,8%. Only the drug resistance did matter notably. Тhe results testify to the high efficiency of the surgical treatment and the acceptable level of the early postoperative complications in the patients who underwent pneumonectomy for pulmonary tuberculosis with unilateral localization. Patients with unilateral localization of tuberculosis failed to detect a threshold value of capillary blood flow, which allows to predict the developing of the postoperative complications. Chronic obstructive pulmonary disease in the stage of compensation is not a risk factor for complications. Multiple and extremely drug resistance are significant risk factors for developing of complications.