Impact of surgical sanation of patients with destructive tuberculosis on the prevalence of tuberculosis and mortality of these patients

Abstract

To analyze the impact of surgical sanation of patients with destructive tuberculosis on the prevalence of tuberculosis and mortality of these patients. Treatment strategy for destructive pulmonary tuberculosis de novo was developed in the Sechenov First Moscow State Medical University. This strategy was applied at the Surgical Department of the Regional Tambov Tuberculosis Dispensary in 2013-2017. We formed a register of patients with pulmonary destruction and bacterial excretion and developed a personal treatment plan. All patients were divided into 3 groups (group A - surgical treatment, group B - no surgery due to refusal or discontinuation of treatment, group C - patients with contraindications or no indications for surgical treatment). Treatment efficacy considering closure of destruction cavities and abacillation was maximal in group A - 97.2%, 41.4% in group B and 39.8% in group C. The number of patients with pulmonary destruction and bacterial excretion has decreased by 3.3 times (from 516 to 158) or 69.8% for 4 years of extensive application of surgical treatment protocol. A significant reduction of 'bacillary core' interrupted infection chain and affected the main epidemiological characteristics. Short-term reduction of the incidence of tuberculosis may be expected. However, even more significant impact of this factor should be expected in the long-term period. Surgical treatment of destructive pulmonary tuberculosis improves efficacy of the management of these patients and reduces mortality rate.