First experience of simultaneous extrapleural lung resection with silicone plombage for widespread drug-resistant destructive pulmonary tuberculosis: a case report
- Authors: Krasnikova E.V.1, Lepeha L.N.1, Aliev V.K.1, Tarasov R.V.1, Ergeshova A.E.1, Bagirov M.A.1
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Affiliations:
- Central Research Institute of the Tuberculosis
- Issue: Vol 10, No 3 (2019)
- Pages: 77-82
- Section: Case reports
- URL: https://journals.rcsi.science/clinpractice/article/view/11523
- DOI: https://doi.org/10.17816/clinpract10377-82
- ID: 11523
Cite item
Abstract
Background. The increase of the number of patients with drug-resistant forms of disseminated destructive lung tuberculosis dictates not only expansion of indications for a surgical treatment but development of new intraoperative techniques, which may reduce the risks of postsurgical complications and further progressing of tuberculosis. For a long-lasting chronic course of destructive drug-resistant tuberculosis, it is often impossible to reach the process stabilization necessary for a successful lung resection. Toracoplasty usually performed when the resection intervention is contraindicated is not only traumatic for a patient but also does not provide the proper lung compression.
Clinical case description. The clinical case is presented by disseminated fibrous-cavernous tuberculosis with a wide drug resistance of the pathogen, with the cavernous changes observed against the background of the pronounced lung tissue cirrhosis. To achieve the effect, we performed extrapleural lung resection followed by the immediate extrapleural silicone plombage in order to prevent overextension of the remaining part of the lung. The histological study data confirm the significant degree of the tuberculosis inflammation activity, in spite of the preceding long-term antituberculosis therapy.
Conclusion. Due to the low trauma and high efficiency, the operation of simultaneous extrapleural pneumolysis with silicone implant plombage may be used in the complex treatment of disseminated destructive pulmonary MDR/XDR TB with a chronic relapsing course of the disease.
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##article.viewOnOriginalSite##About the authors
Elena V. Krasnikova
Central Research Institute of the Tuberculosis
Author for correspondence.
Email: el.krasn@gmail.com
ORCID iD: 0000-0002-5879-7062
SPIN-code: 4252-8340
Senior scientific researcher, Surgical Department
Russian Federation, MoscowL. N. Lepeha
Central Research Institute of the Tuberculosis
Email: lep3@yandex.ru
ORCID iD: 0000-0002-6894-2411
SPIN-code: 6228-8382
докт. биол. наук, профессор, руководитель отдела патоморфологии, клеточной биологии и биохимии
Russian Federation, MoscowV. K. Aliev
Central Research Institute of the Tuberculosis
Email: vilaliev@gmail.com
ORCID iD: 0000-0002-0105-1980
SPIN-code: 7069-7778
мл. науч. сотр.
Russian Federation, MoscowR. V. Tarasov
Central Research Institute of the Tuberculosis
Email: etavnai@yandex.ru
ORCID iD: 0000-0001-9498-1142
SPIN-code: 4245-1560
лаборант-исследователь отдела хирургии
Russian Federation, MoscowA. E. Ergeshova
Central Research Institute of the Tuberculosis
Email: motilek2790@mail.ru
ORCID iD: 0000-0001-7027-3598
SPIN-code: 6949-9530
врач-хирург 2-го хирургического отделения
Russian Federation, MoscowM. A. Bagirov
Central Research Institute of the Tuberculosis
Email: bagirov60@gmail.com
ORCID iD: 0000-0001-9788-1024
SPIN-code: 8820-5448
докт. мед. наук, руководитель отдела хирургии
Russian Federation, MoscowReferences
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