Surgical treatment of pulmonary tuberculosis in children
Abstract
Objective. To estimate the results of surgical treatment in children, suffering pulmonary tuberculosis.
Materials and methods. The results of surgical treatment of 83 children, suffering pulmonary tuberculosis in Jan. 2008 - June 2019 yrs are presented. Immediate and late results of performance of various operative interventions, rate of tuberculosis recurrence and postoperative morbidity are presented.
Results. Efficacy of operative treatment (arrest of bacterioleak, improvement of clinical state, closure of the destruction cavity, positive roentgenological dynamics) in terms of observation up to10 yrs was observed in 81 (97.6%) patients. Postoperative complications were developed in 11 (13.3%) patients, they have healed conservatively. Tuberculosis recurrence in postoperative period have occurred in (2.4%) patients.
Conclusion. It is possible to enhance the efficacy of treatment in children, suffering pulmonary tuberculosis, using various operative procedures. While selecting the method for surgical treatment of pulmonary tuberculosis in children, the advantage must be given to anatomic resection. Lobectomy constitutes the optimal variant of the operation. During performance of resection in children, in patients with multiresistant tuberculosis or tuberculosis with extended medicinal resistance, for prevention of pulmonary overstretching it is mandatory to apply the methods for the hemithorax volume correction (pneumoperitoneum, phrenicotripsy or one of thoracoplasty procedures).
References
Kumari M, Shah I. Need for Revision of Guidelines for Management of DR-TB in Children. Indian Pediatr. 2017;54(2):164-5. PMID: 28285302.
Galli L, Lancella L, Garazzino S. Recommendations for treating children with drug-resistant tuberculosis. Italian Pediatric TB Study Group. Pharmacol Res. 2016. 105:176-82. doi.org: 10.1016/j.phrs.2016.01.020
Joint TB, HIV and viral hepatitis (JTH) [Internet]. World health organization ; 2018 [cited 2019 feb10]. Available from: https://www.who.int/mediacentre/news/releases/2012/tb_20120321/ru/
Dheda K, Gumbo T, Maartens G, Dooley KE, McNerney R, Murray M, et al. The epidemiology, pathogenesis, transmission, diagnosis, and management ofmultidrug-resistant, extensively drug-resistant, and incurable tuberculosis. Lancet Respir Med. 2017. pii: S2213-2600(17)30079-6. PMID:28344011. doi:10.1016/S2213-2600(17)30079-6.
D'Ambrosio L, Centis R, Tiberi S, Tadolini M, Dalcolmo M, Rendon A, EspositoS, Migliori GB. Delamanid and bedaquiline to treat multidrug-resistant andextensively drug-resistant tuberculosis in children: a systematic review. J Thorac Dis. 2017;9(7):2093-101. PMID: 28840010. doi: 10.21037/jtd.2017.06.16.
Dewan RK, Pezzella AT. Surgical aspects of pulmonary tuberculosis: an update. Asian Cardiovasc Thorac Ann. 2016;24(8):835-46. PMID: 27471312. doi: 10.1177/0218492316661958.
Feshchenko UI, Bilohortseva OI. Tuberkuloz u ditei ta pidlitkiv v Ukraini, dynamika osnovnykh pokaznykiv za 10 rokiv. Ukr. pulmonol. zhurn. 2016;(2):27-9. [In Ukrainian].
Bai L, Hong Z, Gong C, Yan D, Liang Z. Surgical treatment efficacy in 172cases of tuberculosis-destroyed lungs. Eur J Cardiothorac Surg. 2012;41(2):335-40. PMID: 21684172. doi: 10.1016/j.ejcts.2011.05.028.
Unifikovanyi klinichnyi protokol pervynnoi, vtorynnoi (spetsializovanoi) tatretynnoi (vysokospetsializovanoi) medychnoi dopomohy doroslym «Tuberkuloz». Nakaz Ministerstva okhorony zdorovia Ukrainy. 04.09.2014 r. № 620.
Razumovsky AY, Mytupov ZB, Alkhasov AB, Rachkov VE, Pavlov AA, Feoktystova EV, et al. Thorascopic lung resection in children. Vestnyk RHMU. 2009;(6):23-7. [In Russian].
Harris RC, Khan MS, Martin LJ, Allen V, Moore DA, Fielding K, Grandjean L;LSHTM MDR-TB surgery systematic review group. The effect of surgery on theoutcome of treatment for multidrug-resistant tuberculosis: a systematic reviewand meta-analysis. BMC Infect Dis. 2016;16:262. PMID: 27283524. doi:10.1186/s12879-016-1585-0.
Harausz EP, Garcia-Prats AJ, Seddon JA, Schaaf HS, Hesseling AC, Achar J, et. al. Sentinel Project on Pediatric Drug-Resistant Tuberculosis. New and RepurposedDrugs for Pediatric Multidrug-Resistant Tuberculosis. Practice-basedRecommendations. Am J Respir Crit Care Med. 2017;195(10):1300-10. PMID: 27854508. doi:10.1164/rccm.201606-1227CI.
Klotz LV, Lindner M, Hatz RA. Pulmonary Tuberculosis--Is Surgery still Necessary?. Zentralbl Chir. 2015;140 Suppl 1:S36-42. PMID: 26351762. doi:10.1055/s-0035-1546249. [In German].
Marfina GY, Vladimirov KB, Avetisian AO, Starshinova AA, Kudriashov GG, Sokolovich EG, et al. Bilateral cavitary multidrug- or extensivelydrug-resistant tuberculosis: role of surgery. Eur J Cardiothorac Surg. 2018;53(3):618-24. PMID: 29040413. doi: 10.1093/ejcts/ezx350.
Ots ON, Agkatsev TV, Perel'man MI. Surgical treatment for pulmonarytuberculosis with Mycobacterium resistance to drugs. Probl Tuberk Bolezn Legk. 2009;(2):42-9. PMID: 19382642. [In Russian].
Wang L, Xia F, Li F, Qian X, Zhu Y, Chen H, et al. Pulmonary resection in the treatment ofmultidrug-resistant tuberculosis: A case series. Medicine (Baltimore). 2017;96(50):e9109. PMID: 29390307. doi: 10.1097/MD.0000000000009109.
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