Video-assisted thoracoplasty in pulmonary tuberculosis: a retrospective study

BACKGROUND: The long history of the struggle against tuberculosis (TB) inspired us to develop a new minimally invasive technique of thoracoplasty with videothoracoscope control (VATP). The aim of this study was to determine its efficacy. METHODS: We conducted a retrospective single-center study of a cohort of patients operated on between 1999 and 2017. Two hundred eight patients who were indicated for thoracoplasty with verified TB with cavities in the upper lobe/S6 were enrolled in this study. Treatment outcomes were assessed based on Laserson criteria and active TB absence verified with CT. RESULTS: Intraoperative and postoperative complications were observed in 15 (7.2%) and 4 (2.0%) cases, respectively. There were no 30-day mortalities. VATP with curative intent succeeded in 88% of cases according to Laserson criteria and active TB absence verified with computed tomography (CT). Clinical improvement (sputum negativity, closure of caverna, and lack of reactivation for 3 years) was achieved in 81% of cases. CONCLUSIONS: Comparing the successful results of this technique in the cohort of multidrug-resistant (MDR) TB patients with the outcomes of treatment of MDR TB worldwide (77% vs. 55%, respectively), the VATP technique is shown to be efficacious and thus recommended. CLINICAL TRIAL REGISTRY NUMBER: ISRCTN67743278.