Method of treatment of destructive tuberculosis of single lung with extensively drug resistant mycobacteria tuberculosis

Treatment of patients with TB with total defeat of one lung and presence of destruction in the other, with a constant allocation of extensively drug resistant Myc.tuberculosis (XDR MBT), remains extremely weak. Under these conditions, the role of surgical and endoscopic therapies is rising. Objective: To improve treatment of patients with fibrous-cavernous tuberculosis of a single lung with XDR MBT due to valvular lung volume reduction (VLVR) and local extrapleural thoracoplastic. Material and methods: The treatment was performed in 13 patients (10 men, 3 women) of fibrous-cavernous tuberculosis of a single lung with XDR MBT. The patients9 age ranged from 30 to 54 years. Disease duration ranged from a half to 8 years, all patients were smear. The essence of the proposed method is to use endobronchial non-return valve. Valve ensures the smooth discharge of air, sputum, bronchial content in the exhale, and cough. Inverse of air in the lung lesions did not occur. Thus, gradually hypoventilation was being reached, until atelectasis of lung tissue. VLVR performed during treatment with reserve anti-TB drugs. In 6 patients with VLVR was supplemented extrapleural thoracoplastic. Results: Time that valve spent in the bronchus depended on the rate of cavity closure and cessation of bacteria and ranged from 7 to 274 days. Abacillation was achieved in 100% of patients, the cavity was closed in 76,9% of patients. Conclusions: The proposed method of treatment of patients with tuberculosis enables us to reduce lung cavity and reach abacillation patients with XDR MBT in the absence of the effect of chemotherapy with reserve anti-TB drugs and a high risk of single lung resection.