RESUMO
Resection operations performed on the lung using endoscopic techniques are divided into VATS and video-assisted thoracoscopy. Our experience with VATS in patients with pulmonary tuberculosis and other respiratory disorders is 66 transactions. Complications in the postoperative period were not observed. The advantages of VATS in phtiziosurgical practice are high information content, reducing the time of diagnosis; reduction in the number of patients receiving test treatment, improve treatment quality and outcome of disease through early diagnosis verification, reducing economic losses due to refusal of the trial unreasonably prolonged courses of therapy for tuberculosis in the absence of radiographic dynamics.
Assuntos
Empiema Tuberculoso , Neoplasias Pulmonares , Cirurgia Torácica Vídeoassistida/métodos , Tuberculose Pulmonar , Adolescente , Adulto , Empiema Tuberculoso/diagnóstico , Empiema Tuberculoso/cirurgia , Humanos , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/cirurgia , Pessoa de Meia-Idade , Cirurgia Torácica Vídeoassistida/instrumentação , Resultado do Tratamento , Tuberculose Pulmonar/diagnóstico , Tuberculose Pulmonar/cirurgia , Adulto JovemRESUMO
333 patients with chronic tuberculous empyema were treated in the Central Military Clinical Tuberculous Hospital N 4. Among them there were 325 (97,6%) men and 8 (2,4%) women. The patients' age varied from 18 to 87 years. The main causes of empyema development were the following: the exudative pleurisy--in 179 (53,8%) cases, the complications of lung resection--in 69 (20,7%), the ineffective artificial pneumothorax--in 50 (15,0). In 34 (10,2%) patients the empyema was the result of spontaneous pneumothorax and in 1 (0,3%) patient it developed due to generalization of tuberculosis of extra-pulmonary localization. The treatment was based on extensive surgical interventions performed in patients during the stable and subacute phases of pathologic process. It allowed achieving the good results in 89,2% and satisfactory results--in 9,9% patients.
Assuntos
Empiema Tuberculoso/cirurgia , Pleura/cirurgia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Doença Crônica , Terapia Combinada , Empiema Tuberculoso/diagnóstico por imagem , Empiema Tuberculoso/tratamento farmacológico , Empiema Tuberculoso/etiologia , Empiema Tuberculoso/microbiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pleura/diagnóstico por imagem , Pleura/microbiologia , Radiografia , Resultado do TratamentoRESUMO
The outcomes of surgical treatment in 323 patients aged 18 to 87 years who had chronic tuberculous empyema are analyzed. The duration of the disease ranged from 4 to 54 years. The clinical picture was mild with few symptoms and a stable phase to severe with signs of pyoresorptive fever in an acute phase. A programme has been developed to treat patients with tuberculous empyema, which is based on a combination of total specific chemotherapy, local action on a tuberculous process, and final surgical intervention. The basic surgical interventions were pleurectomy and decortication of the lung in 124 (38.8%) patients; pleurectomy with decortication and resection of the lung in 31 (9.6%); pleurectomy, decortication with resection of the lung in 11 (3.4%). Forty three (13.3%) patients underwent plastic surgery with thoracoplasty and pleuropulmonectomy and 110 (34%) patients had palliative interventions as closed drainage. Postoperative complications occurred in 12.6% of patients. One patient died from progressive tuberculosis.