title: Surgical intervention for pulmonary tuberculosis: analysis of indications and perioperative data relating to diagnostic and therapeutic resections.
abstract: OBJECTIVE
  To analyze the data on patients operated on for pulmonary tuberculosis (TB) with (Group I) or without (Group II) a correct TB diagnosis and preoperative anti-TB treatment.
  
  
  METHODS
  Between 1980 and 1997, 144 resections for TB (Groups I+II) were performed. The 80 patients in Group I underwent therapeutic resections: 32 cases involved recurrent cavities or tuberculomas, three involved post-TB bronchiectasis, 13 involved progression of cavities or tuberculomas, and 32 involved persistent tuberculomas after 6 months of anti-TB therapy. The 64 patients in Group II were operated on for a suspicion of malignancy in 49 cases, for cavitary lesions with haemophthysis in six cases, for multiple lesions in seven cases, and for recurrent hydrothorax in two cases.
  
  
  RESULTS
  Groups I and II included 0 and five pneumonectomies, 32 and 29 lobectomies, 48 and 20 wedge resections, 0 and nine videothoracoscopic biopsies, and 0 and one hilar lymphadenectomy, respectively. In Groups I and II, the mean duration of postoperative hospitalization was 13.2 and 10.4 days, and the frequency of postoperative pneumothorax was 11.25 and 4.6%, respectively. The incidence of bronchopleural fistula was 1.25 and 0%, the mortality was 0 and 3.1%, and the morbidity was 53.7 and 35.9% in Groups I and II, respectively. Two patients with active disease died in Group II. Pathology demonstrated that the frequency of acid-fast bacilli in Groups I and II was 40 and 25%, respectively.
  
  
  CONCLUSIONS
  Patients without a correct preoperative TB diagnosis underwent more extensive parenchyma resection. Postoperative complications increased when acid-fast bacilli were present. The lack of preoperative anti-TB treatment did not involve a higher risk of minor complications, but death occurred only in this group.
authors.affiliation: Division of Thoracic Surgery, Faculty of Medicine, University of Szeged, A. Szent-Györgyi Centre of Medicine and Pharmacy, H-6726 Szeged, Hungary. fj@surg.szote.u-szeged.hu
authors.forename: J
authors.initials: J
authors.lastname: Furák
authors.forename: I
authors.initials: I
authors.lastname: Troján
authors.forename: T
authors.initials: T
authors.lastname: Szöke
authors.forename: L
authors.initials: L
authors.lastname: Tiszlavicz
authors.forename: Z
authors.initials: Z
authors.lastname: Morvay
authors.forename: E
authors.initials: E
authors.lastname: Csada
authors.lastname: Balogh A
mesh_terms: D000328:Adult; D000368:Aged; D000904:Antibiotics, Antitubercular / Q000008:administration & dosage* / Q000009:adverse effects; D001706:Biopsy; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008168:Lung / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy; D011183:Postoperative Complications / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000601:surgery; D011292:Premedication; D012008:Recurrence; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D020775:Thoracic Surgery, Video-Assisted; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000601:surgery*
chemical_list: D000904:Antibiotics, Antitubercular