INFLUENCE
OF PULMONARY TUBERCULOSIS ON SURGICAL TREATMENT OF NON-SMALL CELL LUNG CANCER
V.A.Tarasov, G.M.Boyarkin, A.F.Malinovskij,
M.K.Kalechenkov
PURPOSE: to assess influence of pulmonary tuberculosis (TBC) on surgical
treatment of non-small cell lung cancer (NSCLC).
MATERIALS
AND METHODS: A non-randomized concurrent cohort
comparison study. 223 NSCLC patients treated between 1996 and 2000 were divided
into 2 groups statistically similar by age, sex, and stage of cancer: NSCLC
with concomitant or previous TBC (TBC+NSCLC) - 108 cases, and NSCLC alone - 115
cases. Differences in functional inoperability, morbidity and mortality rates,
intraoperative blood loss, pleural adhesions, duration of operation, kind and
peculiarities of surgical procedures, intra- and postoperative complications in
both groups were evaluated statistically.
RESULTS: In TBC+ NSCLC group, more patients were found functionally inoperable than
in NSCLC group. The rate of pneumonectomies was higher in TBC+ NSCLC group.
Extended procedures with intrapericardial pulmonary vessel ligation were more
often in TBC+ NSCLC group due to severe hilar sclerosis, while there were more
chest wall resections in NSCLC group. Due to posttuberculous pleural adhesions,
coefficient of correlation between duration of the procedures and
intraoperative blood loss in group TBC+NSCLC was 0.668 versus 0.424 in group
NSCLC (both groups ***). There were more intraoperative complications in TBC+
NSCLC group (mainly, massive hemorrhages as a result of pleural cavity
obliteration). Bronchial stump dehiscence was more likely to develop in
TBC+NSCLC group (6.1% versus 4.1% in NSCLC group), being most frequent in
patients with concomitant active TBC.
CONCLUSIONS: Concomitant TBC decreases patients' fitness for surgery and increases
rate of severe intra- and postoperative complications.
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