Browsing by Author "Amare, Hiwot Yeshitila"

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    Surgical outcome of pleuro-pulmonary Tuberculosis complications:A five year retrospective study,Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia
    (Addis Abeba University, 2020-10) Amare, Hiwot Yeshitila; Tamire, Ayalew Tizazu(MD ,Associate professor of Cardiothoracic Surgery, AAU )
    Background Tuberculosis is one of the top ten causes of mortality in the world. It is more concerning for African countries as most of the young productive age group is the target of the disease. In the older days surgery was the main mode of management for pulmonary tuberculosis. Since the invention of anti-tuberculosis chemotherapy the role of surgery has reduced. But due to the emergence of drug resistant TB and post TB complications, surgical management is growing again. The current indications of surgery for pulmonary tuberculosis are post TB squelae and drug resistant Tuberculosis. The commonest post TB complications demanding surgery are Empyema, hemoptysis, destroyed lung, bronchiectasis, fistulas, and tuberculoma. After all medical evolutions, surgical management of TB is still one of the challenges for thoracic surgeons. Here we will see the trends of surgical interventions and outcome in terms of post-operative complication in our hospitals. Methods – It is a retrospective cross sectional case study done in Ethiopia, Addis Ababa University, college of health science, School of Medicine Tikur Anbessa Hospital, Department of surgery, cardiothoracic and vascular surgery unit on patients who underwent surgery for pathologies secondary to pulmonary Tuberculosis from January1, 2015-December31, 2019. Result – 88 patients were participants of the study. There were 59 men and 29 women. Mean age is 33.5, Maximum 65 years and Minimum 16 years with the range of 21-45. More than 90% of the patients had productive cough and 53.4% had hemoptysis. Eight patients had history of comorbidity. Only two patients were smokers. All patients had chest X-ray and 97.7% had CT scan of the chest. Out of the 88 patients 56 of them had pathology on the left side. 13.4% of patients had anemia up on presentation. Albumin level was measured in 43.1% of the patients. Out of these patients 73.6% had normal albumin level, 13.1% had mild hypoalbuminemia 10.5% moderate hypoalbuminemia, and 2.5% had severe hypoalbuminemia. Only 20% of the patients were screened for HIV infection. The mean operation time was-186 min/ (minimum 40 min, Maximum 440min). Mean total Hospital Stay was 27 days (minimum 7days, Maximum 86 days). For 57% of the patients Post op hospital stay was <14 days and 42% had stayed >14 days. The most common indication for surgery was empyema followed by Aspergilloma. The most common procedure performed is decortication followed by pneumenectomy and wedge resection. We observed a complication rate of 20% with mortality rate of 1.1%. The most common complication detected was atelectasis followed by BPF and pneumonia. Conclusion- In general Outcome of surgical management for pulmonary tuberculosis is good with relatively low morbidity and mortality. We recommend offering patients surgery on the appropriate time when having proper indication.