Single-stage bilateral VATS lungs resection from the unilateral access in patients with pulmonary tuberculosis

Abstract

Purpose of the Study: To compare the effectiveness of single-stage bilateral pulmonary resection (SBPR) from unilateral intercostal-mediastinal access with video-assisted thoracoscopy (VATS) and consecutive bilateral pulmonary resection (CBPR) in treatment of patients with destructive pulmonary tuberculosis (TB). Material and Methods: An open, randomized, controlled, prospective clinical trial of 189 patients with bilateral destructive TB was conducted. In the 1st group (n=91), the SBPR with the VATS was performed from unilateral intercostal-mediastinal access, in the 2ndgroup (n=98), the CBPR was performed. Despite specific adequate chemotherapy, 44.0% of the 1st group and 50.0% of the 2nd group patients (p=0.41 χ2) were smear or/and culture positive. Among them, the MDR-TB was detected in 32.5% of the 1st group and 36.7% of the 2nd group (p=0.68 χ2). Results: The developed method of SBPR showed high efficacy. Intraoperative blood loss of less than 300 ml in the 1st group was observed in 96.7% patients, in the 2nd group - in 68.4% (p