Invasive technologies in the complex treatment of tuberculosis in children and adolescents: from the past to the present (literature review)

Abstract

Invasive technologies in the complex treatment of tuberculosis in children and adolescents have a long history, which began in the pre-antibiotic period. This is the way of their improvement from independent use of artificial pneumothorax and pneumoperitoneum to the use of these techniques in the complex treatment of respiratory tuberculosis during the development of chemotherapy for the disease. New technology uses valvular bronchial blocking. That procedure creates hypoventilation and atelectasis in the affected region of the lung with preservation of drainage function of the blocked bronchus and destruction cavity, which allow reducing indications for surgical treatment as a method with a high level of injury rate. The approaches to surgical intervention in children and adolescents with respiratory tuberculosis have also changed. It is also part of the comprehensive treatment of the disease. Minimally invasive accesses under the control of video-assisted thoracoscopy are used, which significantly reduced the risk of surgery and increased the immediate efficiency of surgical treatment. New technologies combined with all types of surgeries are being widely developed: electro- and argon plasma coagulation and pleurodesis, vaporization of the tuberculous lesion, and encapsulated pleura by high-energy CO2 laser, new materials (polypropylene implants) are used. Further development of invasive technologies with multiple and extensively drug-resistant Mycobacterium tuberculosis, to children and adolescents compensates for the lack of efficiency of conservative chemotherapy and is an urgent problem at the present stage of pediatric phthisiology.