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J Thorac Cardiovasc Surg 1996;111:662-670
© 1996 Mosby, Inc.

GENERAL THORACIC SURGERY

SURGICAL MANAGEMENT OF PLEUROPULMONARY TUBERCULOSIS

Received for publication Sept. 28, 1994 Accepted for publication May 10, 1995. Address for reprints: Jérôme Mouroux, MD, Service de Chirurgie Abdominale et Thoracique, Hôpital Pasteur, B.P. 69, 06002 Nice Cedex, France.

Abstract

To define the current indications for surgical management of pleuropulmonary tuberculosis and analyze the results of operative procedures, the records of 59 patients operated on between January 1987 and December 1993 were reviewed. Three patient categories were defined. Group I patients (n= 25) underwent operation for diagnostic purposes: solitary mediastinal node or mediastinal adenopathy associated with pulmonary lesions (n= 10), pulmonary infiltrates (n= 4), pulmonary nodules or masses (n= 10), or chronic pleurisy (n= 1). Postoperative mortality and morbidity rates in this group were both 4%. Group II patients (n= 18) underwent operation for active lesions: intrapulmonary cavity (n= 6), destroyed lung parenchyma (n= 6), or chronic loculated pleural effusion (n= 6). Postoperative morbidity and mortality rates were 16.6% and 5.5%, respectively. Group III patients (n= 16) underwent operation for a complication of therapy or for sequelae of previously "cured" tuberculosis: calcified pyothorax (n= 8), empyema (n= 2), fistulized nodes (n= 2), bronchiectasis (n= 3), or aspergilloma (n= 1). Morbidity and mortality rates in this group were 31.25% and 12.5%, respectively. Surgery continues to have both diagnostic and therapeutic indications for management of pleuropulmonary tuberculosis, despite the morbidity and mortality rates associated with operative procedures. (J THORACCARDIOVASCSURG1996;111:662-70)

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