Pulmonary mycobacterioses: surgical aspects of diagnostics and treatment

Abstract

Goal: to investigate efficiency of surgical diagnostics and treatment of pulmonary mycobacteriosis.Materials and methods: 31 patients diagnosed with pulmonary mycobacteriosis underwent surgery. Should mycobacteriosis be not diagnosed before the surgical intervention, the surgery was performed as per standard indications for fibrous cavernous pulmonary tuberculosis or tuberculoma.Results. There were 20 segmental resections, 4 lobectomies (with МАС-, M. kansasii-infection), 5 pneumonectomies (with M. xenopi and M. fortuitum-infection), 2 combined resections. The causative agent was isolated out of surgical specimens in 11 (35.4%) patients; in 10 patients (32.3%) mycobacteriosis was confirmed by detection of non-tuberculous mycobacteria in sputum or bronchial lavage along with the detection of the causative agent in the resected tissue. In the remaining 10 (32.3%) patients non-tuberculous mycobacteria were detected only in sputum and/or bronchial lavage before surgical interventions. Post-surgery complications were observed in 6 (19.4%) of patients, lethal outcome due to myocardial infarction. Clinical cure was achieved in 29 (93.6%) patients.

Keywords

• микобактериоз
• диагностика
• оперативное вмешательство
• лечение