Effectiveness of simultaneous surgical treatment of patients with tuberculosis of multiple localizations: respiratory organs and lumbar spine

Objective: to show the effectiveness of simultaneous surgical treatment of patients with tuberculosis of multiple localizations: tuberculosis of the lungs and the lumbar spine.

Materials and Methods. Simultaneous surgical treatment was performed in 24 patients. Evaluation of the effectiveness of treatment was carried out according to the signs of the early and later (after 12 months) postoperative period. Operational material for detection microbiologically and morphologically to determine its causative agent, drug sensitivity and inflammation activity.

Results: the effectiveness of simultaneous surgical treatment was 87.3 %. The number of complications in the early postoperative period was 8.4 % (n = 2), in the late 4.2 % (n = 1). According to the results of the examination of the surgical material, tuberculosis was confirmed in 20 patients (83.3 %), both in the bone structure and in the lung tissue. In 4 (16.7 %) patients, nonspecific inflammation of the bone structure was noted.

Conclusion: Simultaneous surgical treatment of tuberculosis of the lungs and lumbar spine is a highly effective method of treating tuberculosis of multiple localizations. It is possible to recommend the use of simultaneous surgical treatment for simultaneous sanitization of foci of infection, both in the lung tissue and in the spine.

1. Nechaeva О.В. The epidemic situation of tuberculosis in Russia. Tuberculosis and lung diseases. 2018;96(8):15-24. https://doi.org/10.21292/2075-1230-2018-96-8-15-24 (In Russ).

2. Perelman M.I., Naumov V.N., DobkinV.G. [et al.]. Indications for surgical treatment of patients with pulmonary tuberculosis. Tuberculosis problems. 2002;2:51-55. (In Russ).

3. Шулутко М.Л. Хирургическое лечение туберкулёза лёгких (опыт и перспективы). Проблемы туберкулёза. 2001 ;2:25-27. [Shulutko M.L. Surgical treatment of pulmonary tuberculosis (experience and prospects). Tuberculosis problems. 2001 ;2:25-27. (In Russ)].

4. Garg R.K., Sovanshi D.S. Spinal tuberculosis: a review. J.Spinal Cord Med. 2011 ;34(5):440-454. https://doi.Org/10.1179/2045772311Y.0000000023

5. Kulchavenya E.V., Koveshnikova E.Yu., Zhukova 1.1. Clinical and epidemiological features of modern tuberculous spondylitis. Tuberculosis and lung diseases.2013;1:41-45. (In Russ).

6. Dowie, J. Wildman M. Choosing the surgical mortality threshold for high risk patients with stage la non-small cell lung cancer: insights from decision analysis. Thorax. 2002;57(1):7-10.

7. Kabakov D.G., Bazarov D.V., Vyzhigina М.А., Axelrod B.A., Morozova A.A., Kavochkin A. A., Belov Yu.V. Risk factors of simultaneous operations in combination of lung cancer and cardiovascular pathology. Bulletin of Anesthesiology and Resuscitation. 2018;15(5):87-94. https://doi.org/10.21292/2078-5658-2018-15-5-87-94 (In Russ).

8. Bazarov D.V. Simultaneous operations in thoracic surgery. Doctor. 2017;10:2-6. (In Russ).

9. Dykhno Yu. A. Simultaneous operations for lung cancer. Siberian Journal of Oncology. 2009;1:83-85. (In Russ).

10. Parshin V.V. et al. Simultaneous operations for non-tumor tracheopesophageal fistula in combination with cicatricial stenosis of the trachea. Bulletin of Surgical Gastroenterology. 2016;3:164-164. (In Russ).

11. Dartevelle P.G. Extended operations for the treatment of lung cancer. Annals of thoracic surgery. 1997;63:12-19.

12. Elami A., Korach A., Rudis E. Lung cancer resection or aortic graft replacement with simultaneous myocardial revascularization without cardiopulmonary bypass. CHEST Journal. 2001 ;119(6)4 941-1943.

13. Perelman M.l. Combined operations on lungs and other organs. Annals of Surgery. 1996; 1:28-31. (In Russ).

14. Clinical recommendations of the Ministry of Health of the Russian Federation "Tuberculosis in adults". Moscow, 2014:72. (In Russ).