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Treatment Outcome of Surgical Complications of Pleuropulmonary Tuberculosis in Niger Delta Region of Nigeria

Eyo E. Ekpe, John U Ekott, Victor A. Umoh.

AIM: Although essentially a medical condition, ignorance, non-compliance with treatment and late presentation encourage development of complications that require surgical intervention. This study aimed to investigate the clinico-pathologic characteristics of our pleuropulmonary tuberculosis patients with surgical complications and the outcome of surgical treatment offered.
METHODS: Case files of pleuropulmonary tuberculosis patients who were surgically treated for complications of their disease in the cardiothoracic surgery unit of the University of Uyo Teaching Hospital between November 2006 and October 2008 were retrospectively studied. Data on demography, socio economic parameters, clinical presentation, radiological/investigation findings, diagnosis, treatment and outcome were collated for analysis.
RESULTS: Out of 156 patients with pleuropulmonary tuberculosis diagnosed and treated by the Directly Observed Therapy Unit of the Hospital during the study period, 33 (21.2%) of them suffered surgically treated complications. The patients consisted of 19 males and 14 females (M:F = 1.3:1) with age range 2-68 years and mean 36.3 years. Seven types of surgically treated complications of pleuro-pulmonary tuberculosis were encountered including pleural effusion in 39.4%, broncho-pleural fistula (spontaneous pneumothorax) in 21%, empyema thoracis in 12%, emphysematous bulla (9.1%), lung abscess (6.1%), haemoptysis (9.1%), and a case of destroyed lung syndrome (3.0%) Surgical treatment given to the patients included closed tube thoracostomy drainage (69.7%), Monaldi tube decompression (9.1%), and thoracotomy and decortication (3.0%).
CONCLUSION: The prevalence of surgically treated complications of pulmonary tuberculosis in this study is 21.2%, and we recommend a high index of suspicion, contact tracing and strict adherence to the modus operandi of directly observed continuous combined anti-tuberculous chemotherapy for pleuropulmonary tuberculosis.

Key words: Pleuropulmonary tuberculosis, Surgical complications, Treatment outcome

Article Language: Turkish English

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