Precision resection of pulmonary tuberculoma using Nd:YAG-laser

Abstract

The objective of the study: a comparative study of immediate and long-term results of pulmonary tuberculoma precision resection with Nd:YAG-laser with a wavelength of 1,318 nm and atypical resection with suturing devices.Subjects and Methods. Two groups of 58 patients each were compared. The groups were comparable in terms of gender, age, the nature of the concomitant pathology and the main pathological process. In Group I, patients were operated on using precision 1,318-nm Nd:YAG-laser resection, and in Group II, the sublobar resection with suturing devices were used.Results. The mean duration of hospital stay in Groups I and II was 19.10 ± 6.02 and 19.20 ± 6.02 days respectively (p > 0.05), the duration of surgery made 65 [55; 75] and 55 [45; 60] minutes (p > 0.05), the mean volume of surgical blood loss was 50 [33; 70] and 70 [50; 165] ml (p > 0.05), and the mean duration of pleural cavity drainage after surgery was 4 [3; 5] and 4 [3; 6] days (p > 0.05). Statistically significant differences were noted in the mean volume of the resected part of the lung: 14.0 ± 7.4 mm3 in Group I versus 95.0 ± 9.7 mm3 in Group II (p ≤ 0.05). The complete clinical and radiological cure was achieved in 70% of patients in Group I and 82% in Group II. According to MSCT data, in 91.6% of cases, a thin linear scar is formed in the area of precision intervention.Conclusion: The surgical methods are comparable in terms of immediate and long-term results but precision laser resection minimizes the removal of intact tissue during the removal of tuberculomas.