Surgical management of hemoptysis in pulmonary tuberculous patients

Abstract

ObjectivesPulmonary Tuberculosis (TB) is a disease that is often treated medically. However, medical treatment usually fails in the management of tuberculosis – related hemoptysis. In this study, we aimed to assess the role of surgery in the treatment of hemoptysis due to pulmonary TB. MethodsFifty two patients presented by hemoptysis and underwent pulmonary resection were enrolled in this study. Patients were divided into two groups according to the timing of surgical procedures: Group A (n = 22) included patients who underwent surgery within two days of presentation which was major to massive hemoptysis causing hemodynamic instability. Group B (n = 30) included patients who underwent surgery within 4 days after presentation with hemoptysis which was persistent and minor. ResultsThere was no significant difference in the demographic data between both groups. Major and massive hemoptysis were the common presentation of group A, whereas minor hemoptysis was the main presentation in group B. Tuberculous cavities were the most common lung lesions in both groups (40.9% in group A, versus 40% in group B). Lobectomy was the main surgical procedure performed in both groups (50% in group A, versus 56.7% in group B). Regarding the complications, Bronchopleural fistula occurred in one case in each group after pneumonectomy. Recurrent hemoptysis occurred in only one case in group A. There was one case (4.5%) of mortality in group A. ConclusionEarly pulmonary resection in patients with hemoptysis is an effective and safe method to insure good outcome. Limited resections are associated with higher incidence of recurrence.