Thoracoplasty in the treatment of pulmonary tuberculosis

Saugman, Chr.

doi:10.1016/s0041-3879(20)80087-7

Cited by 1 publication

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“…Several attempts were made to modify the surgery, such as the anterio-lateral approach (10) or rib flap forming, in which it is turned inwards after extensive pneumolysis (11). According to the data from that time, thoracoplasty indications were solitary thin-walled caverns in the upperposterior segments of the upper lobes or S6 of the lungs without focal dissemination (12)(13)(14). In modern conditions, such morpho-radiological changes serve as indications for lung resections (15).…”

Section: Indicationsmentioning

confidence: 99%

Video-assisted thoracoplasty in pulmonary tuberculosis: a retrospective study

Гиллер

Giller

et al. 2020

J Thorac Dis

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Background: The long history of the struggle against tuberculosis (TB) inspired us to develop a new minimally invasive technique of thoracoplasty with videothoracoscope control (VATP). The aim of this study was to determine its efficacy.Methods: We conducted a retrospective single-center study of a cohort of patients operated on between 1999 and 2017. Two hundred eight patients who were indicated for thoracoplasty with verified TB with cavities in the upper lobe/S6 were enrolled in this study. Treatment outcomes were assessed based on Laserson criteria and active TB absence verified with CT.Results: Intraoperative and postoperative complications were observed in 15 (7.2%) and 4 (2.0%) cases, respectively. There were no 30-day mortalities. VATP with curative intent succeeded in 88% of cases according to Laserson criteria and active TB absence verified with computed tomography (CT). Clinical improvement (sputum negativity, closure of caverna, and lack of reactivation for 3 years) was achieved in 81% of cases. Conclusions: Comparing the successful results of this technique in the cohort of multidrug-resistant (MDR) TB patients with the outcomes of treatment of MDR TB worldwide (77% vs. 55%, respectively), the VATP technique is shown to be efficacious and thus recommended.Clinical trial registry number: ISRCTN67743278.

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