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Abid Demircan
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Ann Thorac Surg 2005;79:299-302
© 2005 The Society of Thoracic Surgeons

Original article: General thoracic

Surgical Management of Tuberculosis-Related Hemoptysis

Abdullah Erdogan, MDa,*, Arif Yegin, MDb, Gülsüm Gürses, MDa, Abid Demircan, MDa

a Department of Cardiothoracic Surgery, Akdeniz University Faculty of Medicine, Antalya, Turkey
b Department of Anesthesiology, Akdeniz University Faculty of Medicine, Antalya, Turkey

Accepted for publication May 3, 2004.

* Address reprint requests to Dr Erdogan, Akdeniz Universitesi Hastanesi, GKDC Anabilim Dali, 07058 Antalya, Turkey
aerdogan66{at}hotmail.com

BACKGROUND: Tuberculosis is a disease that is often treated with chemotherapy. However, medical treatment usually fails in the management of tuberculosis-related hemoptysis. In this paper, we review our experience in the surgical treatment of tuberculosis-related hemoptysis.

METHODS: Fifty-nine patients with tuberculosis-related hemoptysis (46 men, 13 women) who underwent surgical treatment were enrolled in this study. A thoracotomy was performed urgently in 21 patients with massive (>600 mL daily) hemoptysis, and within the first 2 days in 24 with major (200 to 600 mL daily) hemoptysis, and within the first 4 days in 14 with persistent minor (<200 mL daily) hemoptysis.

RESULTS: A chest roentgenogram showed cavitary lesion in all of the patients with massive hemoptysis (21 patients), in 22 of 24 patients with major hemoptysis, and in 3 of 14 patients with persistent minor hemoptysis. Pneumonectomy was performed in 4 patients, lobectomy in 39 patients, and segmentectomy or wedge resection in 16 patients. The average hospitalization period was 13 days. The mortality rate was 6.8% perioperatively. Of the patients deceased, 3 were intubated with a single-lumen endotracheal tube and 1 with a double-lumen endotracheal tube. During the postoperative period, empyema and bronchopleural fistula developed in 3 patients, and no other severe complications occurred. The average postoperative follow-up period was 3 years. The number of thoracotomies for tuberculosis performed in the years from 1995 to 2003 was significantly decreased, compared with the years between 1985 to 1994 (p = 0.042).

CONCLUSIONS: In tuberculosis-related hemoptysis, thoracotomy with double-lumen endotracheal intubation and resection of the cavity may be curative and lifesaving.






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