Surgery for lung tuberculosis and related lesions: change in clinical presentation as a consequence of migration of population

: In spite of better health care organization and improvement in medical treatment, the incidence of newly diagnosed cases of tuberculosis has not declined in our region as anticipated and a number of patients still require surgery for lung tuberculosis and related lesions. Thus 92 patients were operated in our institution during the 1972-1991 period. Indications for surgery were: medical treatment failures (13%), mass lesions of the lung (31%) and mediastinum (12%), complications of the disease (38%) or from previous operations (6%). The proportion of immigrants (47%) was significantly higher than expected from their relative number. They also had a tendency to have more advanced or complicated forms of disease (61% vs 49% in local natives). As a probable consequence of this, surgical resections were more aggressive in immigrants. The operative mortality was similar in both groups. This change of presentation of lung tuberculosis is a new challenge to our local strategy in treating this disease.