Tuberculous lymphadenopathy: a review of results of surgical treatment.

Eighty consecutive cases of tuberculous lymphadenopathy confirmed by histological examination were reviewed. Fifty-five cases (69%) were followed up for more than two years. Excluding twelve cases with incomplete chemotherapy, the results of treatment by combined surgery and chemotherapy in the remaining 43 cases were analysed. Twelve cases had complete excision of all grossly involved lymph nodes; all did well. Twenty-one cases had only representative lymph nodes biopsied for diagnosis, five of them (24%) required a second operation--three for abscess formation and two for progressive enlargement of the residual lymph nodes. Seven cases of tuberculous abscesses were treated by a simple drainage procedure, and despite chemotherapy, all had persistent wound discharge for over one month which required a second operation to remove the underlying caseating lymph nodes. Results suggest that all easily accessible tuberculous lymph nodes should be removed and that persistent discharging sinuses should also be treated by surgery.