Three years’ experience of tuberculosis versus non-tuberculosis cases of bronchopleural fistula repair at Dr. Soetomo General Academic Hospital Surabaya

Abstract

Link of Video Abstract: https://youtu.be/DVqGIPOyWR0 Background: Tuberculosis (TB) continues to be a significant health issue and causes various complications, especially in developing countries. Bronchopleural fistula (BPF) is a rare and potentially life-threatening complication of pulmonary tuberculosis that needs to be treated by surgical procedure. This research aimed to compare the outcome of post-operative BPF repair caused by Tuberculosis and non-Tuberculosis cases. Methods: In this retrospective review, we include patients from post-operative repair of BPF with Tuberculosis and non-Tuberculosis cases from January 2020 to December 2022 who were admitted to our primary center. Preoperative, operative and postoperative data were collected from medical records. We identified 36 patients and analyzed the differences between TB and non-TB groups. Results: There were 36 patients with BPF who underwent surgery. The mean age of the subjects was 47.940±15.288 years. Out of these, 25 subjects (69.4%) had TB, while 11 (30.6%) subjects did not. Among the subjects, 14 TB patients (38.9%) and 2 non-TB patients (56%) experienced recurrent pneumothorax before surgery. Statistical analysis showed a significant association between comorbid TB and the occurrence of secondary attack BPF before surgery (p = 0.035). Regarding the duration of post-operative drain placement, 22 TB patients (61.1%) had the drain placed for less than 7 days, while 3 subjects (8.3%) had it for more than 7 days. Among the non-TB patients, 10 subjects (27.8%) had the drain placed for less than 7 days, and only 1 subject (2.8%) had it for more than 7 days. The statistical analysis showed no association between the TB group and the duration of post-operative drain placement (p=0.798). Conclusion: There are numerous post-operative complications and morbidities following BPF repair surgery. Patients with TB who undergo BPF repair surgery are significantly associated with secondary attack BPF before surgery.