Analysis of the results of the surgical treatment of tuberculosis in children

Abstract

Tuberculosis (TB) in children is a complex of medical, biological and social problem of both international and national importance for many countries of the world and remains one of the main causes of death in the world. Surgical treatment can improve the results of treatment of children with TB.Objective — to familiarize a wide range of doctors with their own experience in the surgical treatment of children and adolescents with pulmonary TB.Materials and methods. The results of surgical treatment of 79 children with lung tuberculosis in the period from 2008 to 2018 are reported.Results and discussion. Male adolescents prevailed among the operated patients. The male/female sex ratio is 45 (57.0 %)/34 (43.0 %). The average age of patients was 13.1 years (from 4 to 17 years). The overall effectiveness of surgical treatment in the observation period up to 10 years was 97.5 %. Sputum conversion, improvement of the clinical condition, closure of the cavities and positive X-ray dynamics in 77 patients (97.5 %). Postoperative complications developed in 11 (13.9 %) patients and were eliminated conservati­vely. Recurrences of TB in the postoperative period were observed in 2 (2.5 %) patients.Conclussions. Surgical treatment is possible by increasing the effectiveness of treating children with TB. The peculiarity of the course of TB in children is more frequent than in adults, the impression of a specific process of the tracheobronchial tree. The overall effectiveness of surgical treatment of pulmonary TB in children in follow-up periods up to 10 years was 97.5 %. In the surgical treatment of TB of the lungs in children, preference should be given anatomical resection, the best option for surgery is lobectomy. Minimally invasive resections of the lungs have advantages over traditional surgical interventions, can reduce the injury of the operation and reduce the period of postoperative inpatient treatment. When performing resection in children with multidrug-resistant TB and preXDR TB, to prevent overdistension of the lungs, methods of correcting hemithorax volume should be used. The presence of limited destruction in the opposite lung is not an obstacle to the resection of the lung.