Evaluation of surgery of thoracic Tuberculosis in patients referred to Imam Khomeini Hospital in 1367-76

Davoodabadi, A. and Rahim, M.B. and Razi, E. (1999) Evaluation of surgery of thoracic Tuberculosis in patients referred to Imam Khomeini Hospital in 1367-76. Feyz Journal of Kashan University of Medical Sciences, 3.

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Official URL: http://feyz.kaums.ac.ir/article-1-514-en.html


History and Objectives: Due to epidemiology of Tuberculosis in Iran and the consequent mortality and diagnostic therapeutic surgical measures and in order to determine the status of patients and the various diagnostic and surgical techniques, this study was carried out in patients referring to Imam Khomeini hospital in Tehran in the years 1367-1376. Materials and Methods: This study was performed by existing data recorded in the records of patients undergone surgical pulmonary resection and/or diagnostic procedures. Tuberculosis was diagnosed by sputum culture and tissue pathology. Age, sex, occupation residential place during these ten years, clinical manifestations and paraclinical examinations type of resection and complication of the surgery were evaluated. Results: During 10 years a total of 500 patients with pulmonary and thoracic Tuberculosis were studied 44 of patients were female and the other 56 were male. The patients were 15-20 years old. Complications of Tuberculosis were 5 times more common in males as females and pericardial involvement was twice in men than women. The most common occupations were house-keeping and workers. The most common clinical manifestations were pleuritic chest pain (82), dyspnea (80) and cough (78). PPD was negative in 50 of patients. The differential leukocyte count was neutrophils 73, lymphocytes 24 and the remainder were eosinophils and basophiles. ESK was abnormally elevated in 88 of the patients. Pulmonary resection was done in 34 of patients. Total pericardiectomy and pericardial window were performed in 18 and 6 of patients respectively. Limited diagnostic thoracotomy for hilar lymphadenopathy and SPN was performed in 24 of the cases. All paraclinical examinations were negative in these patients despite the presence of pulmonary Tuberculosis. Clavicular resection was performed in 6 of patients. Eloesser flap in 6 and superior vena cave obstruction in 2 diagnostic thoracotomy was performed in these cases. Conclusion: complication in men aged 15-20 years were five times the women. Pericardial involvement was also twice more common in men than women. The patients were often housekeeper or workers. In 24 of patients who were suspicious to have Tuberculosis all paraclinical examinations were negative but limited thoracotomy confirmed Tuberculosis. One patient in this group had upper lobe Tuberculosis accompanied by squamous cell carcinoma of the lung. Therefore thoracotomy is recommended in these cases and lung cancer should be considered whenever Tuberculous involvement of the upper lobe especially its anterior segment is present. In our series mortality and morbidity were 4 and 12 respectively that are compatible with foreign reports.

Item Type: Article
Subjects: Surgery
Divisions: Feyz journal
Depositing User: ART . editor
Date Deposited: 15 May 2017 14:44
Last Modified: 25 May 2017 14:16
URI: http://eprints.kaums.ac.ir/id/eprint/2611

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