1. Video-assisted thoracoplasty in pulmonary tuberculosis: a retrospective study
- Author
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V.V. Koroev, Yakub G. Imagozhev, D.B. Giller, Galina V. Giller, B.D. Giller, Galina V. Scherbakova, A A Glotov, and Oleg Sh. Kesaev
- Subjects
Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Tuberculosis ,business.industry ,Retrospective cohort study ,030204 cardiovascular system & hematology ,medicine.disease ,Surgery ,Clinical trial ,03 medical and health sciences ,0302 clinical medicine ,030228 respiratory system ,Pulmonary tuberculosis ,Active tb ,Cohort ,medicine ,Sputum ,Original Article ,Video assisted ,medicine.symptom ,business - Abstract
Background: The long history of the struggle against tuberculosis (TB) inspired us to develop a new minimally invasive technique of thoracoplasty with videothoracoscope control (VATP). The aim of this study was to determine its efficacy. Methods: We conducted a retrospective single-center study of a cohort of patients operated on between 1999 and 2017. Two hundred eight patients who were indicated for thoracoplasty with verified TB with cavities in the upper lobe/S6 were enrolled in this study. Treatment outcomes were assessed based on Laserson criteria and active TB absence verified with CT. Results: Intraoperative and postoperative complications were observed in 15 (7.2%) and 4 (2.0%) cases, respectively. There were no 30-day mortalities. VATP with curative intent succeeded in 88% of cases according to Laserson criteria and active TB absence verified with computed tomography (CT). Clinical improvement (sputum negativity, closure of caverna, and lack of reactivation for 3 years) was achieved in 81% of cases. Conclusions: Comparing the successful results of this technique in the cohort of multidrug-resistant (MDR) TB patients with the outcomes of treatment of MDR TB worldwide (77% vs . 55%, respectively), the VATP technique is shown to be efficacious and thus recommended. Clinical trial registry number: ISRCTN67743278.
- Published
- 2020