title: Surgical treatment efficacy in 172 cases of tuberculosis-destroyed lungs.
abstract: OBJECTIVE
  Compared to the use of anti-TB drugs for the treatment of tuberculosis (TB), surgery is destructive and is associated with higher risk. Whether surgery is needed for the treatment of TB-destroyed lungs (for short: destroyed lungs) is still controversial and unresolved in the clinic.
  
  
  METHODS
  Retrospective analysis of treatment efficacy was performed on 172 cases of destroyed lungs (176 surgeries) in the Thoracic Surgery Department of our hospital from April 1992 to June 2010.
  
  
  RESULTS
  A total of 83 male and 89 female patients was analyzed. The youngest patient was 7 years old, and the oldest was 72 years old, with a mean age of 38.4 years. A total of 120 cases had a preoperative cough, 31 cases had fever, and 42 cases had hemoptysis. A total of 49 cases was positive for Mycobacterium tuberculosis by sputum test before surgery, yielding a positive TB rate of 28.5% (49/172). A total of 116 patients had a destroyed left lung and 56 cases had a destroyed right lung. In all, 110 cases underwent total pneumonectomy, 37 pleuropneumonectomy, one lobectomy, 10 residual lobectomy, two total pneumonectomy and tracheoplasty, 11 cases bronchopleural fistula (BPF) repair and other surgeries, and one case underwent thoracoplasty. A total of four patients underwent thoracoplasty 30 days after surgery due to a thoracic cavity infection or empyema. The overall perioperative mortality rate was 2.9% (5/172). The surgical complication rate was 18.6% (32/172). The sputum negative conversion rate was 87.8% (43/49), and the clinical cure rate was 91.9% (158/172).
  
  
  CONCLUSIONS
  Our findings suggested that surgical treatment efficacy in destroyed lungs was satisfactory with strict surgical indications, standard preoperative anti-TB treatment, adequate preoperative preparation, and careful intraoperative operations.
authors.affiliation: Department of Chest Surgery, Beijing Research Institute of Tuberculosis and Thoracic Tumors, Beijing Chest Hospital attached to Capital Medical University, Beijing, China. bailianqi6@hotmail.com
authors.forename: Lianqi
authors.initials: L
authors.lastname: Bai
authors.forename: Zheng
authors.initials: Z
authors.lastname: Hong
authors.forename: Changfan
authors.initials: C
authors.lastname: Gong
authors.forename: Dongjie
authors.initials: D
authors.lastname: Yan
authors.forename: Zikun
authors.initials: Z
authors.lastname: Liang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000995:Antitubercular Agents / Q000494:pharmacology; D002648:Child; D024901:Drug Resistance, Multiple, Bacterial; D005260:Female; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000187:drug effects / Q000302:isolation & purification; D011013:Pneumonectomy / Q000009:adverse effects / Q000379:methods; D012189:Retrospective Studies; D013183:Sputum / Q000382:microbiology; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D018088:Tuberculosis, Multidrug-Resistant / Q000601:surgery; D014397:Tuberculosis, Pulmonary / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000601:surgery*; D055815:Young Adult
chemical_list: D000995:Antitubercular Agents