Single article

DOI: 10.47026/2413-4864-2021-4-18-28

Ivanov A.V., Malov A.A., Kichigin V.A., Ivanov V.A., Tarasova L.V.

The Use of Thoracoplasty in the Treatment of Destructive Pulmonary Tuberculosis

Keywords: pulmonary tuberculosis, mortality, thoracoplasty, body mass index, drug resistance, negative reaction of the sputum

Despite a decrease in the incidence of pulmonary tuberculosis in the Russian Federation in recent years, among the newly diagnosed patients there remains a significant proportion of patients with bacterial excretion and destructive pulmonary tuberculosis. In patients with destructive pulmonary tuberculosis, surgical treatment is often the only possible method for saving lives. We studied the results of extrapleural posterosuperior thoracoplasty in 42 patients with destructive pulmonary tuberculosis. The comparison group consisted of 30 patients who received medicamentous therapy. The mortality rate for 3 years of follow-up in the conservative treatment group was 36.7%, in the surgical treatment group it was 23.8%, p = 0.237. Among patients with more than 2 years of disease experience, mortality was 45% in the main group, 88% in the comparison group, p = 0.070. In the absence of drug resistance, mortality in the main group was 4%, that in the comparison group – 14.2%, p = 0.283. Mortality in individuals with normal body weight was lower in the group of patients who underwent thoracoplasty than in the comparison group: 17.6% vs. 33.3% (p = 0.202). Among those who did not achieve sputum negative reaction, mortality was lower, and passing to the 3rd group of dispensary care was more common in the surgical treatment group – 41.7% vs. 71.4% (p = 0.077) and 33.3% vs. 21.4% (p = 0.426). Among patients with drug resistance or low body weight or unachieved sputum negative reaction, mortality rates were comparable in both groups. Thus, thoracoplasty, in comparison with conservative therapy, makes it possible to improve treatment results in patients regardless of the length of the disease in groups with Mycobacterium tuberculosis sensitive process, with normal body weight, with preservation of elimination of bacilli. The effectiveness of thoracoplasty decreases in patients with an increase in the disease duration.

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About authors

Ivanov Andrey V.
Thoracic Surgeon, Tuberculosis Pulmonary Surgery Department, Republican Tuberculosis Dispensary, Russia, Cheboksary (vasilich0518@mail.ru; )
Malov Alexey A.
Candidate of Medical Sciences, Thoracic Surgeon, Head of the Tuberculosis Pulmonary Surgical Department, Republican Tuberculosis Dispensary, Russia, Cheboksary (zaved1969@yandex.ru; )
Kichigin Vadim A.
Candidate of Medical Sciences, Associate Professor, Department of Faculty and Hospital Therapy, Chuvash State University, Russia, Cheboksary (vadim-kichigin@mail.ru; ORCID: https://orcid.org/0000-0002-9161-2066)
Ivanov Vasily A.
4th Year Student, Medicine Faculty, Chuvash State University, Russia, Cheboksary (ivanovasiliy12@mail.ru; )
Tarasova Larisa V.
Doctor of Medical Sciences, Head of the Department of Faculty and Hospital Therapy, Chuvash State University, Russia, Cheboksary (tlarisagast18@mail.ru; ORCID: https://orcid.org/0000-0003-1496-0689)

Article link

Ivanov A.V., Malov A.A., Kichigin V.A., Ivanov V.A., Tarasova L.V. The Use of Thoracoplasty in the Treatment of Destructive Pulmonary Tuberculosis [Electronic resource] // Acta medica Eurasica. – 2021. – №4. P. 18-28. – URL: http://acta-medica-eurasica.ru/en/single/2021/4/3/. DOI: 10.47026/2413-4864-2021-4-18-28.