[Surgical management of lungs destroyed by tuberculosis].
OBJECTIVE
The purpose of this work was to report our experience with surgical management of lungs destroyed by tuberculosis and to analyze our results.


METHODS
We reviewed the cases of 45 patients who underwent surgery between January 1978 and December 2004 after medical treatment for pulmonary tuberculosis considered successful. The series included 31 men and 14 women, mean age 31 years (range: 7-55 yr). Indications for surgery were chronic bronchorrhea (91.1%) and hemoptoic sputum associated with bronchorrhea (8.9%). Lung function tests were preformed in 42 patients and noted a restrictive syndrome with shunt in all: mean FEV1 was 1 890 ml. All patients were given a preoperative medical regimen for at least four weeks. Pneumectomy (17 right and 28 left) was performed; all bronchial sutures were made manually and protected. Operative bleeding was a constant feature and blood transfusion was needed (mean 1,500 cc).


RESULTS
Operative mortality was 4.4% from hemorrhagic and infectious causes. Complications were non-fatal (16.3%) and marked by bleeding (0.9%) empyema with bronchopleural fistulae (8.9%). Mean postoperative hospital stay was 13 days without empyema and 150 days with empyema. Long-term outcome was satisfactory after a mean 7.5 years follow-up (range: 4 months - 20 years).


CONCLUSIONS
Indications are patient comfort and necessity. Morbidity and mortality are acceptable with adequate preoperative preparation.
Kendja
F
F
Service de Chirurgie Thoracique et Cardiovasculaire, Institut de Cardiologie, BPV 2006, Abidjan, Côte d'Ivoire. kendjaflavien@voila.fr
Tanauh
Y
Y
Kouamé
J
J
Demine
B
B
Amani
A
A
Kangah
M
M
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007902:Length of Stay; D008168:Lung / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy / Q000379:methods*; D011183:Postoperative Complications; D012129:Respiratory Function Tests; D012189:Retrospective Studies; D014397:Tuberculosis, Pulmonary / Q000150:complications*