Altemur KARAMUSTAFAOĞLU, Adnan SAYAR, Zeki GÜNLÜOĞLU, M. Ali BEDİRHAN, Orhan TAŞÇI, Akif TURNA, Atilla GÜRSES

Tüberküloz cerrahisi sonuçlarımız

Tüberküloz dünyada ölüm nedenleri arasında 5. sırayı almaktadır. Bu haliyle tüberküloz medikal tedavinin başarısına rağmen, komplikasyonlan açısından halen göğüs cerrahisinin uğraş alanıdır. Biz bu çalışmada 20 yıllık tüberküloz cerrahisi sonuçlarımızı sunuyoruz. Ocak 1980-Temmuz 2000 tarihleri arasında Yedikule Göğüs Hastalıkları ve Göğüs Cerrahisi Eğitim ve Araştırma Hastanesi'nde yatarak tedavi gören 41.576 akciğer tüberkülozu tanısı almış hastadan majör cerrahi yapılan 282 hasta (%0.68) retrospektif olarak incelendi. Yapılan çalışmada, mortalitemiz %5, morbiditemiz %40 olarak gerçekleşti. Mortalite nedenlerimiz; 5 olguda (%35.7) solunum yetmezliği, 2 olguda (%14.2) sepsis, 2 olguda (%14.2) bronkopleural fistül + ampiyem, 2 olguda (%14.2) dissemine intravasküler koagülasyon, 1 olguda (%7.1) tüberküloz endobronşit (hemoptizi), l olguda (%7.1) böbrek yetmezliği, l olguda (%7.1) pulmoner emboli olarak belirlenmiştir. Morbidite nedenlerimiz ise bronkop-levral fistül, ampiyem, pnörnoni, uzamış hava kaçağı, kanama, yara yeri infeksiyonu, rezidü plevral boşluk ve şilotorakstır. Kabul edilebilir bir morbidite ve mortalite ile tüberküloz cerrahisi, günümüzde hala uygulanan bir yaklaşımdır.

Surgical management of pulmonary tuberculosis

Tuberculosis has been the fifth leading death cause in the world. Although, it is a medical problem, management of complications is the subject of thoracic surgery. in this study, we aimed to evaluate the surgical results of complicated pulmonary tuberculosis. A retrospective study. Yedikule Hospital for Pulmonary Disease and Thoracic Surgery. Two hundred eighty two surgically operated patients out of 41.576 patient (i.e., 1.4%) who were administred to our hospital between January 1980 and July 2000. Our mortality was 5%, while the morbidity rate was found to be 40%. Causes of mortality were; respiratory insufrıciency in 5 patients (35.7%), septicemia in 2 patients (14.2%), brochopleural fıstula and empyema in 2 patients (14.2%), disseminated intravascular coagulopathy in 2 patient (14.2%), hemoptysis due to endobronchial tuberculosis in l patient (7.1%), pulmonary embolism in 1 patient (7.1%) and renal failure in 1 patient (7.1%). The complications are bronchopleural fıstula, empyema, pneumonia, prolonged air leak, postoperative hemorrhage, incision site infection, residual thoracic space and cyhlothorax. Surgical intervention in surgically suitable tuberculosis has been a widely approved ma-nagement with a acceptable morbidity and mortality rate.

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