Under conditions of tuberculosis epidemic resective methods come to be used more and more seldom, the causes of which fact being resistance of Koch's bacilli to antibacterial drugs, extension and duration of the process. Collapsosurgical interventions constitute an alternative to resecting methods but such operations are accompanied by complications in 11 to 22 percent of cases. The author suggests that pneumoperitoneum be used to prevent complications developing in thoracoplasty, substantiating his suggestion, validating it by submitting the relevant statistical material.
Operations were performed on 102 patients (93 with tuberculomas, 2 with fibrocavernous tuberculosis, and 7 with infiltrative tuberculosis of the type of caseous pneumonia) without preoperative chemotherapy. Certain difficulties in identification of the nature of the disease in tuberculomas are pointed out. It is shown that only emergency histological study helps to avoid errors. Postoperative complications occurred in 5.9% of patients. Exacerbation of tuberculosis after economical resections in tuberculomas occurred in 2.1% of patients due to a nonradical intervention. The expediency of early interventions which allow the term of treatment to be shortened is shown.
The article presents the analysis of the operations for tuberculosis in 1976 (Group 1) and in 1985 Group 2). The results studied in 1983 and 1989, respectively, are as follows: in a postoperative period a full clinical effect was produced in 78 out of 80 patients in Group 1, and in 190 out of 196 in Group 2. The studies of the longterm outcomes revealed that 67 out of 79 patients in Group 1 and 171 out of 178 in Group 2 were considered as cured ones. It was concluded that to evaluate the operation effectiveness after the intervention, there must be at least 3 years of the patient's follow-up. It seems advisable to form a high risk group in relation to tuberculosis reactivation and to subject such patients to correcting interventions along with lung partial resection.