Modern morbidity following pulmonary resection for postprimary tuberculosis

Adriano Rizzi, Gaetano Rocco, Mario Robustellini, Gerolamo Rossi, Claudio Della Pona, Giuseppe Vertemati

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Abstract

Between January 1991 and March 1996, a total of 28 patients with postprimary tuberculosis underwent resection for disease progression (n = 81, multidrug resistance or noncompliance to the medical treatment (n = 11), parenchymal sequelae (n = 3), suspected cancer (n = 5), and for the correction of postpneumonectomy bronchopleural fistula and empyema (n = 1). On admission, eight patients presented with sputum positivity 128.6%). Similar to previous series, tubercular predilection for upper lobes was confirmed (21/28, 75%); accordingly, upper lobectomy through an extrapleural approach was the most common procedure (16/28, 57.1%). Atypical segmental resections or segmentectomies were performed in seven patients (25%), whereas a bilobectomy was necessary in another three patients (10.7%) and a completion pneumonectomy in one (3.6%). Additional procedures were an open- window thoracostomy with transpericardial closure of the main bronchus and a tailored thoracoplasty. No operative mortality was reported. Healing was achieved in 26 patients (93%). Bleeding, either from the chest wall or hilar dissection, was the only reported intraoperative complication. Median blood loss, inclusive of early postoperative collections from chest tubes, reached 1330 ml (range 100-3700 ml). Major postoperative complications included recurrent disease (2/28, 7%) in sputum-positive patients and segmental pulmonary embolism (3.5%). Causes of minor morbidity were air leaks resulting in residual space undergoing spontaneous resolution (18%), wound breakdown (14%), and, fever (11%). This limited series confirms the therapeutic value of the surgical treatment of postprimary tuberculosis, provided that correct indications, adequate pre- and postoperative medical coverage, and meticulous technique are applied.

Original languageEnglish
Pages (from-to)488-491
Number of pages4
JournalWorld Journal of Surgery
Volume21
Issue number5
DOIs
Publication statusPublished - Jun 1997

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ASJC Scopus subject areas

  • Surgery

Cite this

Rizzi, A., Rocco, G., Robustellini, M., Rossi, G., Della Pona, C., & Vertemati, G. (1997). Modern morbidity following pulmonary resection for postprimary tuberculosis. World Journal of Surgery, 21(5), 488-491. https://doi.org/10.1007/PL00012274