Rodríguez Macarena, Munita Sepúlveda José Manuel, Pérez Daniel, Bannura Felipe, Rodríguez Juan Carlos, Rodríguez Patricio
Servicio de Medicina, Hospital Padre Hurtado, Facultad de Medicina, Clínica Alemana-Universidad del Desarrollo, Hospital INER y CT.
Rev Med Chil. 2009 Feb;137(2):234-9. Epub 2009 Jun 10.
Surgical treatment for pulmonary tuberculosis is mainly limited to the management of sequelae such as bronchiectasis, hemoptysis and brochopleural fistulae.
To review the data of patients who underwent surgical treatment for pulmonary tuberculosis.
Retrospective review of 33 patients aged 18 to 73 years (24 males) who underwent lung resection surgery for the management of pulmonary tuberculosis. Follow-up data were obtained from outpatient visit records and registries of the national tuberculosis program.
The reasons to perform surgery were the following: fifteen for hemoptysis, nine for lung destruction and nine for an active and multiresistant disease. No patient died in the postoperative period. The morbidity observed included empyema (n =5), pneumothorax (n =2), bronchopleural fistula (n =2) and hemothorax (n =2). At six months of follow up, six of the nine patients with active tuberculosis had negative acid-fast bacilli on sputum smear. Two of these patients died, one due to respiratory failure and another by an unrelated cause. Both dead patients had negative acid-fast bacilli on sputum smear.
Surgery in pulmonary tuberculosis has a high rate of complications but may be useful in selected patients.
肺结核的外科治疗主要局限于对诸如支气管扩张、咯血和支气管胸膜瘘等后遗症的处理。
回顾接受肺结核外科治疗患者的数据。
回顾性分析33例年龄在18至73岁(24例男性)因肺结核接受肺切除手术的患者。随访数据来自门诊病历和国家结核病项目登记处。
手术原因如下:咯血15例,肺毁损9例,活动性及多重耐药疾病9例。术后无患者死亡。观察到的并发症包括脓胸(n = 5)、气胸(n = 2)、支气管胸膜瘘(n = 2)和血胸(n = 2)。随访6个月时,9例活动性肺结核患者中有6例痰涂片抗酸杆菌阴性。其中2例患者死亡,1例死于呼吸衰竭,另1例死于无关原因。两名死亡患者痰涂片抗酸杆菌均为阴性。
肺结核手术并发症发生率高,但对部分患者可能有用。