Morphological studies of the surgical material to determine the form­phase and the degree of activity of the tuberculosis process when using minimally invasive surgical treatment techniques

Abstract

Objective — to analyze the morphological studies of the operating material with the determination of the form-phase and the level of activity of the tuberculous process using minimally invasive methods of surgical treatment.
 Materials and methods. A retrospective analysis of data for a five-year period was conducted in our clinic. A total of 165 cases of pulmonary or pleural tuberculosis were treated. Patients were of different age groups. The men were 88 (53.3 %), women — 77 (46.6 %). All patients underwent morphological examination of the surgical material. Morphological determination of the degree of activity of specific inflammation in the lung tissue was carried out according to the previously developed working classification of the degree of activity. The morphological definition of the phase of pleural tuberculosis was determined according to previously developed criteria. Investigated histological preparations of lung tissue and tissue of the parietal pleura, stained by the traditional method with hematoxylin and eosin.Microbiological examination of biological material (sputum and/or fragments of surgical material) in each case to identify mycobacterium tuberculosis was carried out using various methods, regulated by Order of the Ministry of Health of Ukraine N 45.
 Results and discussions. The largest share of surgical interventions was in patients with pulmonary tuberculoma — 46.6 % of cases, with tuberculomas more often there was a moderate degree of activity of a specific inflammatory process. With various forms of pulmonary tuberculosis, moderate activity of the inflammatory process is more often determined — 51.8 %, in 13.4 % of cases the progression of specific inflammation is established. The share of microbiological detection of MBT at the time of surgery in cases of tuberculous lesions of the lungs was 27.7 % of cases, the share of multi-resistant MBT strains or strains with extended resistance was 61.3 %. In tuberculous pleurisy, the result of a microbiological study showed M. tuberculosis in 90.6 % of cases, more often susceptible MBT strains were determined — 58.5 %.
 Conclusions. Morphological study of surgical material in VATS provides an objective biological determination of the form of the phase of tuberculous lesion and determination of the degree of activity of a specific inflammatory process, which is extremely necessary for the further appointment of adequate treatment of patients.