Surgical treatment of tuberculous cold abscess of the chest wall.
The incidence of tuberculosis (Tbc) infection is high in some parts of the world and tuberculous cold abscess of the chest wall (CACW) often fails to respond to medical treatment. Medical records of 178 patients who underwent surgical treatment of chest wall abscesses from July 1970 to Sept. 2000 were reviewed and 89 patients who were pathologically confirmed as Tbc cold abscess cases were included in this study. Their ages ranged from 9 to 71 years (mean 33.3 years) and the male to female ratio was 1.2:1 (49 male, 40 female). The symptoms were palpable chest wall mass, pain and pus discharge, and three patients had multiple lesions. Twenty-five patients (28%) underwent excision of chest wall abscesses and 64 patients (72%) underwent chest wall and rib resection. Tbc medication was given preoperatively in 39 patients for an average of 6.3 months and all patients were given Tbc medication postoperatively for an average of 12 months. Postoperative complications were bleeding, pus discharge, empyema, pleural effusion, wound dehiscence, subcutaneous emphysema and activation of pulmonary Tbc. The disease recurred in 7 patients (7.8%) and these 7 patients all underwent a second operation. We recommend preoperative Tbc medication and complete resection of chest wall abscesses including any suspicious ribs. Postoperative Tbc medication for a minimum of 12 months is essential to decrease the risk of a relapse.
Paik
Hyo Chae
HC
Department of Thoracic and Cardiovascular Surgery, Yonsei University College of Medicine, C.P.O. Box 8044, Seoul 120-752, Korea.
Chung
Kyung Young
KY
Kang
Jeong Han
JH
Maeng
Dae Hyeon
DH
D000038:Abscess / Q000188:drug therapy / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000995:Antitubercular Agents / Q000627:therapeutic use; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013896:Thoracic Diseases / Q000188:drug therapy / Q000601:surgery*; D019616:Thoracic Surgical Procedures; D013904:Thoracic Vertebrae / Q000601:surgery; D014376:Tuberculosis / Q000188:drug therapy / Q000601:surgery*
D000995:Antitubercular Agents