Tuberculosis and Surgery

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Tuberculosis and SurgeryAmong infectious diseases, in the fight against which surgery is called upon to play an important role, one of the first places, undoubtedly, should be put tuberculosis, or, as it is sometimes abbreviated as TBTs.

Surgical methods of treatment of osteoarticular and pulmonary tuberculosis in recent years have become increasingly important.

It used to be thought that opening a tuberculosis focus or removing it is a dangerous step leading to the spread of tuberculosis infection, that this is, figuratively speaking, the "gateway to death." Therefore, in osteoarticular tuberculosis, resection (removal) of a part of the joint was performed far beyond the boundaries of the affected area. This led to the fact that the operated limb was shortened, movements in it were limited. It is not surprising that patients rarely agreed to such treatment. In the meantime, tuberculosis was "doing its job", destroying the skeleton. Tuberculous fistulas appeared, from which pus was secreted for years, profound changes in the body occurred ...

In case of pulmonary tuberculosis, operations were almost not performed at all, with the exception of burning out pleural adhesions and imposing an artificial pneumothorax.

The situation is different today, although now, as before, the basic general rules for the treatment of tuberculosis are observed. First of all, the patient is provided with improved living conditions, prescribed a special diet, work and rest. These are the basic conditions for the successful treatment of tuberculosis patients. Antibacterial therapy also plays an important role in the fight against this disease. The use of special anti-tuberculosis drugs - Pasca, streptomycin, ftivazide, cycloserine, endoxan, etc. - has a positive effect on the course of the disease. Treatment of tuberculosis now always begins and ends with the use of drugs that kill pathogenic bacteria that suppress the development of the tuberculosis process.

However, very often the use of chemicals is not enough, the pathological process subsides, but is not completely cured. Then surgical treatment is required. Thanks to the improvement of surgical techniques, surgical methods in combination with the use of chemicals have become completely safe and, moreover, simply necessary for the successful completion of treatment.

Currently, for osteoarticular tuberculosis, operations are performed at an early stage in the development of the process, when the tuberculous focus is in the bone and did not have time to spread to the joint. Under these conditions, it is possible to maintain the mobility of the joint, and the patient will soon recover. If the process has captured only the joint, the surgeon seeks to remove only the affected part of it, in order to preserve the mobility of the joint, if possible. These operations are especially often performed for tuberculosis of the knee, hip joint and some others.Tuberculosis and Surgery

Great strides have been made in the development of surgical treatment of spinal tuberculosis. This is a fairly common disease, and it leads to very serious consequences. The vertebrae are destroyed and displaced, the spinal cord is compressed, resulting in paralysis of the limbs.

If the process has subsided, but the displaced vertebrae infringe on the spinal cord stem, then surgery is necessary - the spinal canal is opened, the adhesions are separated and the spinal cord is released from compression. Sometimes, some of the affected vertebrae are removed and replaced with a bone graft that strengthens the spine. After such an operation, some patients who have been deprived of the ability to walk for decades begin to move independently and become able to work.In active forms of spinal tuberculosis, the operation should be preceded by intensive medical treatment.

Surgical methods are also widely used in the treatment of pulmonary tuberculosis. There are a number of forms of pulmonary tuberculosis (tuberculous granulomas, large thick-walled cavities, fibronous-cavernous forms), in which the most effective treatment is surgery - removal of segments of the lungs, lobes of the lung or the entire lung affected by tuberculosis.

These operations became possible with the development of surgical technology, thanks to the use of new devices and instruments, the introduction of intubation anesthesia - a special type of anesthesia that allows you to control the lungs during the operation and regulate the patient's breathing, as well as other scientific advances. Let's talk about some of them in more detail.

Our scientists are credited with creating special devices that allow us to improve the technique of pulmonary surgery and simplify operations on the lungs. The so-called suturers of the root of blood vessels, bronchi and lung tissues are widely used. During the operation, a special apparatus is applied to the lung extracted from the opened chest, which mechanically sutures the vessels of the lung, and, if necessary, the bronchus.

After that, the affected part of the lung is removed. Surgical treatment with such a suture is not only easy to perform, but also absolutely safe for the patient. In addition, the new technique allows you to accurately determine the boundaries of the affected area and preserve healthy parts of the lung.

With pulmonary tuberculosis, as well as with osteoarticular tuberculosis, it is necessary to use antibacterial drugs in the preoperative and postoperative period. There are also such forms of tuberculosis in which surgical treatment is carried out as if in two stages. If burning of adhesions of the lung, pneumothorax, pneumolysis, which are usually carried out in parallel with the use of medications, do not give a result, surgeons are forced to remove part of the lung, and sometimes the entire lung.

Thus, we see that in the fight against tuberculosis, surgical methods of treatment are closely intertwined with therapeutic ones. Therefore, as a rule, special tuberculosis institutes and dispensaries have both therapeutic and surgical departments. In therapeutic departments, treatment with chemical drugs is carried out. Here, patients are identified who need surgical treatment, which is carried out by surgeons.

Osteoarticular and pulmonary tuberculosis are not the only forms of this disease that can be treated surgically. In case of kidney tuberculosis, surgery also gives good results. Recently, surgeons have learned to remove only the affected part of the kidney. Carrying out these operations is greatly simplified by the use of a special apparatus, with the help of which the vessels are not tied up, but are connected with special staple sutures.

The state allocates large funds for the fight against tuberculosis. Health authorities are carrying out a huge preventive work to prevent tuberculosis and its timely detection. Throughout the country, tuberculosis dispensaries have been created, which are entrusted with the responsibility to monitor the timely detection of tuberculosis patients, prevent its development and spread, and create the necessary conditions for tuberculosis patients and those around them.

The health authorities have set the goal of complete elimination of tuberculosis in the country. And surgery takes an important place in the fulfillment of this honorable task.

Kukin N.N. - Ways of surgery

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