Pfannschmidt Joachim, Schönfeld Nicolas
Zentralbl Chir. 2017 Sep;142(S 01):S53-S65. doi: 10.1055/s-0043-109257. Epub 2017 Oct 4.
Today surgical procedures for pulmonary tuberculosis are highly selective but owing to the increasing incidence of multidrug resistant tuberculosis has been becoming more and more relevant. Besides the treatment of tuberculosis foci in multidrug resistance tuberculosis to eliminate the source of relapse, complications as sequelae of tuberculosis are among the most frequent indications for surgery. In patients with cavernous lesions, destroyed lobe or lung, bronchiectasis, pleural empyema or hemoptysis thoracic surgical procedures may be warranted. However, in solitary pulmonary nodules operations with diagnostic purpose are necessary, not only to rule out a potential malignancy, but also to identify a so far unidentified tuberculoma. Considering the heterogenous group of patients with tuberculosis, surgical morbidity and mortality are in the known range for surgical resections in lung cancer patients.
如今,肺结核的外科手术具有高度选择性,但由于耐多药结核病发病率不断上升,其变得越来越重要。除了治疗耐多药结核病中的结核病灶以消除复发源外,结核病后遗症等并发症是最常见的手术指征之一。对于有空洞性病变、肺叶或肺毁损、支气管扩张、胸膜脓胸或咯血的患者,可能需要进行胸外科手术。然而,对于孤立性肺结节,有必要进行诊断性手术,这不仅是为了排除潜在的恶性肿瘤,也是为了识别迄今未被发现的结核瘤。考虑到结核病患者群体的异质性,手术发病率和死亡率处于肺癌患者手术切除的已知范围内。