Sakmamatov Konushbek, Kuznetsova Yulia, Istamov Kylychbek, Shauer Daniil, Tripathy Jaya Prasad, Harries Anthony D, Osmonaliev Kudaibergen, Goncharova Olga
Faculty of Medicine, Ala-Too International University, Bishkek 720000, Kyrgyzstan.
International Charitable Foundation "Alliance for Public Health", 01601 Kiev, Ukraine.
Trop Med Infect Dis. 2023 Jul 31;8(8):393. doi: 10.3390/tropicalmed8080393.
Surgery has played an important role in managing complicated tuberculosis in former Soviet Union countries, including the Kyrgyz Republic. However, published information is limited. This study aimed to document the trend, characteristics and outcomes of tuberculosis patients who underwent thoracic surgery, using routinely collected data. Between 2017 and 2021, 4-7% of tuberculosis patients in the Kyrgyz Republic underwent thoracic surgery in two centres in Bishkek and Osh. In 2021, case records were retrieved in 264 (78%) of 340 patients undergoing thoracic surgery in the country. The most common indications for surgery were pleural exudate/empyema in 127 (44%) and tuberculoma in 83 (32%). Most patients (73%) underwent surgery within 30 days of starting TB treatment. Two-thirds of patients underwent radical surgery, and surgical outcomes were excellent in 99% of patients with one death. Post-operatively, 63 (23%) patients had no TB detected by the histology, with the two most common specified conditions being lung cancer and pulmonary hydatid disease. TB treatment was stopped in these patients. Of the 201 patients with confirmed TB after surgery, TB-treatment success was documented in 163 (81%), died/failure/lost to follow-up in 10 (5%) and not evaluated in 28 (14%). This study shows that thoracic surgery is feasible, safe and effective in the routine programme setting. Recommendations are made to strengthen referral and monitoring systems.
在前苏联国家，包括吉尔吉斯共和国，外科手术在处理复杂结核病方面发挥了重要作用。然而，已发表的信息有限。本研究旨在利用常规收集的数据记录接受胸外科手术的结核病患者的趋势、特征和结局。2017年至2021年期间，吉尔吉斯共和国4%至7%的结核病患者在比什凯克和奥什的两个中心接受了胸外科手术。2021年，该国340例接受胸外科手术的患者中，有264例（78%）的病例记录被检索到。最常见的手术指征是胸腔积液/脓胸，共127例（44%），结核瘤83例（32%）。大多数患者（73%）在开始抗结核治疗后30天内接受了手术。三分之二的患者接受了根治性手术，99%的患者手术结局良好，有1例死亡。术后，63例（23%）患者经组织学检查未发现结核病，最常见的两种特定情况是肺癌和肺包虫病。这些患者停止了抗结核治疗。在术后确诊为结核病的201例患者中，163例（81%）记录了抗结核治疗成功，10例（5%）死亡/治疗失败/失访，28例（14%）未评估。本研究表明，在常规项目环境中，胸外科手术是可行、安全且有效的。建议加强转诊和监测系统。
