Prevention of early postoperative complications after pneumonectomy in patients with progressive destructive pulmonary tuberculosis with multidrug-resistant pathogens

Penagi Surkhab A., Bagirov Mamed A., Mozhokina Galina N.

The article analyzes the effectiveness of surgical treatment of tuberculosis patients undergoing pneumonectomy by preventing early postoperative complications using Pentaglobin. 45 patients with destructive pulmonary tuberculosis with multiple drug-resistant pathogens who underwent pulmonectomy in the early postoperative period were assigned Pentaglobin ® in order to prevent early bronchopulmonary complications. Postoperative period they clinically proceeded smoothly, there was a rapid rehabilitation.Complications in the early postoperative period were observed in two people (4.4%) in the form of empyema of the pleural cavity without fistula formation, which successfully performed the terminal operations of thoracostomy and thoracomioplastic surgery. In 45 patients from the comparison group, who were not administered in the early postoperative period, complications occurred more often (28.8%) and were more severe. The largest proportion among complications was attributed to the inconsistency of the stump of the main bronchus and the development of pleural empyema (46.7%), for the elimination of which stage operations were required.In 2 (13.3%) patients progression of the tuberculosis process in a single lung started, which led to their death. The fatal outcome within the first week after the operation resulted in the postoperative pneumonia of the single lung in 3 of 4 patients. As a result, one third of patients (33.3%) with the most severe complications died within 1 month after the operation. Thus, the use of pentaglobin in the early postoperative period after pneumonectomy allowed a 6-fold reduction in the incidence of complications and avoidable deaths.

Keywords:drug-resistant tuberculosis, surgical treatment, pneumonectomy, bronchopulmonary complications, prophylaxis of complications, Pentaglobin ®