MULTI DRUG RESISTANT TB PATIENTS SURGICAL TREATMENT
- VernacularTitle:ОЛОН ЭМЭНД ТЭСВЭРТЭЙ СҮРЬЕЭТЭЙ ЭМЧЛҮҮЛЭГЧДЭД ХИЙГДСЭН МЭС ЗАСАЛ ЭМЧИЛГЭЭНИЙ ҮР ДҮН
- Author:
Rentsenmygmar Ts
;
Sukhee E
;
Munkhzul B
;
Tsagaan B
;
Batbayar D
;
Javzandulam O
;
Batzaya Ts
;
Uuganbayar G
- Collective Name:National Center Communicable Disease
- Publication Type:Journal Article
- From:Journal of Surgery
2016;20(2):25-29
- CountryMongolia
- Language:Mongolian
-
Abstract:
Introduction: We began treatment of
multi drug resistant tuberculosis first from
2003. At that time there was a 1960 cases and
most of the cases were from Ulaanbaatar,
Darkhan, Selenge, Tuv, Dornod provinces.
From all the cases only 62% or 1058 cases
were included in treatment. From that 336
patient or 19% deceased, 296 patient or 18%
didn’t get a treatment. We did this study
because there were never done any research
or study of surgical treatment of multi drug
resistant tuberculosis in Mongolia.
Materials and Methods: We studied
cases of patients who undergone lobectomy,
since 2007. There were 48 cases of 46
patients, 2 patients surgery were done on
both sides. Respondents aged between 14-
45, 25 male (52%), 23 female (48%), all
patients got a first - line anti-tuberculosis
treatment, such as cat-1, cat-1+cat-2 and 10
variants of these drugs. It was done based
on sputum culture test results of NCCD
TB surveillance and research department’s
laboratory.
Results: From the all patients only
77.08% had undergone surgery within the
first 3 years. 92% patients were diagnosed
with multi drug resistance TB only with the
sputum and sputum culture test results, and
the rest of the patients were diagnosed
using a tissue analyses on the above tests.
It was revealed that HR resistant -91.66%,
HR+(Z,E,S) -3 drugs resistant -18.78%,
HR+(ZSE)-4 or 5 drugs resistant. In the
patients TB lesion locations was on the right
upper lobe 54%, left upper lobe 31%, on
a both upper lobes 85%, cavernous fibrosis
tubercles 60%, combined TB lesions 77%,
tubercles 21%.87.5% of total patients
received a multi - drug resistant TB treatment
between 7 - 24 months prior surgery.
All 48 patients had a totally 69 surgeries.
Surgeries included 9% pneumonectomy,
28% lobectomy, 30% Wedge resection,
23% pleurectomy decortication, 7% Wedge
resection on both sides, one bilobectomy.
There were no complications during the
surgery but 5 of patients had an empyema
after surgery. No fatal cases.Three patients
out of 5 who had a surgery due to pulmonary
hemorrhage developed an empyema after
surgery. Drainage tubes were taken after
the surgery within 2-3 months.Therewere no
complication and escalations in the patients
who received a surgical treatment, after the
surgery from 6 months to 5 years.
Conclusion: In study it shows that surgical
treatment is effective to do after 6 months
of anti-tuberculosis drug treatment in multi -drug resistant TB patients.Also it shows that
combining of medical and surgical treatment
is healing up to 98% in the patients who
were rightly chosen according to surgical
indications.This research result shows that in
our country multi - drug resistant TB surgical
treatment complication is only 10.41%,
which is below in the other countries who
have same anti-tuberculosis drug treatment.
- Full text:W020170329607951480029.pdf
