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Evaluation of patients requiring surgical intervention in tuberculosis: A clinical study

Introduction: Tuberculosis (TBC) is one of the most common forms of pleurisy, pleural effusion and extra pulmonary TBC. Tube thoracostomy is the primary treatment method in massive TBC pleurisy. On the other hand, video-Assisted Thoracoscopic Surgery (VATS) has come to the fore in the diagnosis and treatment of undiagnosed patients. In this study, our aim is to share the results of surgeries in patients with pleural effusion due to TBC or diagnosed with TBC later.

Materials and Methods: Files of patients were analysed retrospectively. Age, gender, symptoms, vital signs, laboratory finding, location of disease, diagnosis, surgical procedure, complications, length of stay, mortality and morbidity were examined. The effects of gender, location of the disease, fluid properties, and surgical procedures on TBC pleurisy were evaluated. The patients treated with surgery were enrolled in the study. Patients who were performed anti-TBC treatment even if they had pleural effusion, underwent relaxing thoracentesis, and did not undergo surgery were excluded from the study. The treatment method which yielded favorable results in surgery was taken into consideration. Tube thoracostomies performed before VATS applications were excluded. Results were analysed using Mann- Whitney U test, Fisher exact test and Multivariate linear regression analysis. P<0.05 was considered significant.

Findings: Sixty-four patients with TBC diagnosed through VATS or thoracotomy and treated with tube thoracostomy were examined. Male gender, right localization and exudative pleural effusion were found to have a significant effect on the development of TBC pleurisy (P<0.05). Furthermore, it was found that tube thoracotomy were more effective in the treatment of TBC pleurisy (P<0.05).

Results: The primary treatment method for TBC pleurisy is tube thoracostomy. Additionally, VATS, which is successful in diagnosis and treatment of undiagnosed TBC, is safe, effective and minimally invasive procedure.

Author(s): Muharrem Cakmak, Atilla Durkan, Mustafa Yilmaz, Mehmet Cagri Goktekin