Diagnostic aspects of surgical interventions in patients with pulmonary tuberculosis

Diagnostic aspects of surgical interventions in patients with pulmonary tuberculosis

D.M. Kutuzova¹, S.Z. Suleimanov¹, M.V. Sinitsyn^1,2

Daria M. Kutuzova, e-mail: daria.kutuzova.94@mail.ru

¹National Medical Research Center of Phtysiopulmonology, Moscow

²Pirogov Russian National Research Medical University, Moscow

Aim: to evaluate significance of a diagnostic surgical intervention in patients with established tuberculosis without bacterial excretion.

Materials and Methods: a retrospective study of diagnostic significance of surgical methods was conducted in patients with pulmonary tuberculosis. Medical documents (medical records, surgical records, bacteriological laboratory data) were studied in 109 patients who underwent a surgical diagnostic intervention. Patients with tuberculomas (n=90) and disseminated pulmonary tuberculosis prevailed (n=14). Cavernous tuberculosis and focal tuberculosis were detected in 3 and 2 patients, respectively. 90 segmental resections, 15 lobectomies, 2 combined resections, and 2 precision lung resections were preformed.

Results: surgical specimens were evaluated in patients with a referral diagnosis of tuberculosis without bacterial excretion, and non-tuberculous diseases were diagnosed in 38 (34.9%) cases. Among them, sarcoidosis (n=13 [34.2%]), lung cancer (n=8 [21.0%]) and mycobacteriosis (n=6 [15.8%]) were the most common. Tuberculosis was confirmed in 71 (65.1%) patients. Mycobacterium tuberculosis (MBT) DNA was obtained from 65 patients. Multidrug resistance and pre-extensively drug resistance of MBT was found in 26/65 (40%) patients, and isolated drug resistance to isoniazid was detected in 4/65 (6.2%) subjects. In the postoperative period, 3 (2.75%) complications were reported. After the surgery, two patients demonstrated a residual cavity which required additional drainage, and one subject had a bronchial fistula. These complications were detected in patients with pulmonary tuberculosis, and they were eliminated during treatment. As for non-tuberculous diseases, patients were referred to special medical institutions to determine further management and treatment strategies.

Conclusion: surgical diagnostic interventions enabled verification of diagnosis in all patients. As a result of examination of surgical specimens, resistance of MBT was found in 30/71 (42.2%) tuberculosis patients. This enabled prescription of appropriate anti-tuberculosis therapy regimens in the postoperative period.

Keywords: tuberculosis, thoracic surgery, verification, non-tuberculous diseases, absence of bacterial excretion, diagnosis, immunological methods, radiation methods, MBT MDR.

For citation: Kutuzova D.M., Suleimanov S.Z., Sinitsyn M.V. Diagnostic aspects of surgical interventions in patients with pulmonary tuberculosis. RMJ. 2026;2:31–35. DOI: 10.32364/2225-2282-2026-2-6