THE MORPHOLOGICAL ANALYSIS IN SURGICAL TREATMENT OF TUBERCULOUS PLEURAL EMPYEMA
DOI:
https://doi.org/10.11603/bmbr.2706-6290.2020.3.11519Keywords:
tuberculosis, tuberculous pleural empyema, videothoroscopy, video-assisted surgical resection, open pleurectomy with decortication of the lungsAbstract
Summary. The analysis of morphological diagnosis of pleural empyema with effective surgical treatment of patients with tuberculous pleural empyema was conducted. The use of minimally invasive videothoroscopical (VTS, VATS) technologies in morphological verification is actual in detection of tuberculous empyema in the 1st, 2nd and 3rd stages of its development. In patients of pleural TB empyema only in 51.2 % the pleural empyema probably was diagnosed in a timely manner, that is, at the stage of possible minimally invasive thoracic surgical (VTS, VATS) treatment. In 48.7 % of patients pleural TB empyema is diagnosed at late stage of the purulent process. Today it is necessary to abandon from tactics of conservative treatment of patients with unexplained character of pleural empyema.
The aim of the study – to increase the possibility of morphological verification of patients with TB pleural empyema, establishing granulomatous inflammation of pleura for implementation of mini-invasive (VTS, VATS) or open (PE with DL) surgical treatment.
Materials and Methods. A retrospective analysis of 685 cases of treatment of patients with TB empyema of the pleura was conducted. Preliminary selection of patients with taking into account the requirements for clinical study by the following criteria based on the analysis of literature data and personal experience was carried out.
Results. The analysis was noted that in both groups with pleural empyema prevailed patients with pulmonary TB and fibrosis pleurisy, which is complicated by suppuration of the pleura.
Conclusions. In patients with TB pleural empyema only in 51.2 % of pleural empyema were diagnosed in timely manner, that is at the stage of possible minimally invasive thoracic surgical treatment.
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