НЕПОСРЕДСТВЕННЫЕ И ОТДАЛЕННЫЕ РЕЗУЛЬТАТЫ ХИРУРГИЧЕСКОГО ЛЕЧЕНИЯ ФИБРОЗНО-КАВЕРНОЗНОГО ТУБЕРКУЛЕЗА ЛЕГКИХ У ДЕТЕЙ И ПОДРОСТКОВ

Abstract

Treatment of cavernous or fibro-cavernous pulmonary ТВ, especially multidrug-resistant (MDR-TB) or extensively drug resistant TB (XDR-TB), in children is a huge challenge. At the same time, the incidence of drug-resistant TB is growing throughout the world year after year. We analyzed treatment outcomes in 65 patients (average age 14.8 ± 2.9 years) with cavernous TB (group 1) and 116 patients (average age 15.6 ± 1.9 years) with fibro-cavernous TB (group 2). Treatment effectiveness was evaluated immediately at discharge from hospital, one year and 2–15 years after treatment according to Lazerson’s criteria. There was no in-hospital mortality. Treatment effectiveness at the time of discharge from the surgery department (sputum conversion and cavity elimination) was 100% in both groups. After one year, treatment effectiveness in group 1 was 100%, in group 2 – 97.4% according to Lazerson’s criteria. Surgery for cavernous TB after 10–12 months of conservative treatment implies lower risks of post-operative complications and relapses as compared to surgery for fibro cavernous TB after 22 or more months of treatment. We affirm that a persistent cavity in the lung tissue is the indication for surgery during the first year of treatment.