Endobronchial valve application in tuberculosis patients with low treatment adherence

<b>Purpose of the Study:</b> To increase the treatment effectiveness in patients with destructive pulmonary tuberculosis (DTB) with low adherence to stay in the hospital and receive anti-tuberculosis drugs by applying the method endobronchial valve installation (EbV). <b>Material and Methods:</b> An open, randomized, controlled, prospective clinical trial of 125 patients with DTB was conducted. Patients were divided into two groups: Group I (n=65) - patients with low treatment adherence, who interrupted therapy in hospital and signed an informed consent for EbV installation. Group II (n=60) - patients with low treatment adherence, who interrupted therapy in hospital and did not signed an informed consent for EbV installation. 93.8% of I group and 95.0% of II group patients were smear or/and culture positive (p=0.99 TTF). MDR-TB were registered in 87.7% and in 86.7% cases in both groups (p=0.37 TTF). Bilateral subtotal dissemination was observed in 89.2% and in 91.7% of I and II groups respectively (p=0.76 TTF). The cavities was localized within the upper lobe in 49.2% and 55.0% cases in both groups (p=0.52 χ²). In 30.8% and 35.0% cases in both groups, cavities more than 3 cm in diameter (p=0.62 χ²) prevailed. Polycavernous lesion was observed in 61.5% and 70.0% cases in both groups (p=0.32 χ²). <b>Results:</b> EbV installation in condition of irregular intake of anti-TB drugs allowed to achieve bacteriological conversion in 57.4% cases and closure of cavities in 63.1% cases during 12 months after EbV application. Among patients who were not treated with EbV and who received therapy irregularly, bacteriological conversion was achieved in 21.1% cases (p=0.001 χ²), closure of decay cavities in 23.3% cases (p=0.001 χ²).