[Clinical and morphological rationales for surgical treatment of lung tuberculomas].

Abstract

The types of lung tuberculomas were determined in 302 patients, with respect to the characteristics of their clinical course and variations in their progression, during clinical, radiological, and morphological follow-ups. Drug-resistant Mycobacterium tuberculosis strains were found 3.4 times more frequently in patients with filled tuberculomas and 1.7 times more often in those with infiltrative-pneumonic types of tuberculomas as compared with layered tuberculomas. Based on the patterns of growth of various types of caseous lesions, a rationale for indications for surgical treatment of lung tuberculomas was developed. The proposed treatment strategy for lung tuberculomas makes it possible to initiate intensive chemotherapy in due time and to improve the efficiency of surgical interventions (98.6%), further reducing the duration of inpatient treatment by a factor of 1.5 and the number of tuberculosis relapses by a factor of 2.