Al Neelain Medical Journal - VOL - 21

Permanent URI for this collectionhttps://repository.neelain.edu.sd/handle/123456789/12047

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Author: search.filters.author.Mohammed Elhaj Hassan Abdulmajeed, Mohamed Elamin Ahmed

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    The Surgical Management of Pluero-pulmonary Tuberculosis in Sudan
    (جامعة النيلين - مركز النيلين الطبي, 2018-01) Mohammed Elhaj Hassan Abdulmajeed, Mohamed Elamin Ahmed
    Abstract The aim of this study is to give a review about tuberculous cases managed by surgery in our country. The study was done at El-Shaab Teaching Hospital which is considered as a referral centre for thoracic surgical cases. All cases in the study have been diagnosed by chest physicians as pulmonary tuberculosis and have commenced the anti-tuberculous treatment. Surgery for pulmonary tuberculosis (TB) has become rather limited. However, it is still required for some sequelae and complications. This is a 3 year study (1 year prospective and 2 years retrospective) of cases operated upon for pulmonary TB at El-Shaab Teaching Hospital- Khartoum-Sudan. Patients and methods: A total of 87 cases underwent surgical procedures for various complications of pulmonary TB. After excluding those managed by tube thoracostomy, all cases were taken up for major thoracic surgical procedures under general anaesthesia with double lumen endotracheal tube. A total of 51 cases were operated for tuberculous empyema, 22 patients for aspergilloma and pulmonary cavity with recurrent haemoptysis, 8 patients for multi-drug resistant tuberculosis and 6 patients for tuberculous bronchiectasis. Lung resections including lobectomy were done for 31 patients, pneumonectomy for 1 patient and wedge resection for 1 case. Postoperative follow up was done for those patients and there was no death. The main postoperative complication was air leak which is found in 26 patients which resulted in delayed early hospital discharge, but has stopped spontaneously. This complication is just found in patients underwent decortications for tuberculous empyema. Broncho-pleural fistula (BPF) has been found in 4 cases but sealed spontaneously later on. Results were better in haemoptysis where the desired outcome was achieved in all cases of aspergilloma and lung cavity. All patients were improved apart from 6 patients who had advanced progressive tubercular disease. Conclusion: Surgery for pulmonary TB is the only option for many tuberculous cases with satisfactory results.