Functional Outcomes of Extrapleural Thoracoplasty in Patients with Destructive Pulmonary Tuberculosis and HIV

The objective : to assess the functional outcomes of extrapleural thoracoplasty among patients with destructive tuberculosis and comorbid human immunodeficiency virus (HIV) 6 months after the performed surgery. Subjects and Methods. 49 HIV/TB co-infected patients were subjected to a retrospective study 6 months after the extrapleural thoracoplasty. A control group comprised similar 49 patients with destructive pulmonary tuberculosis but without HIV infection. The following functional characteristics were analyzed: dynamics of dyspnea, vital capacity of lungs (VC), forced expiratory volume of the air exhaled in the first second (FEV1), the Tiffeneau-Pinelli index and indicators of the pulmonary capillary blood flow (PCB). Results . In MG, extrapleural thoracoplasty contributed to the healing of cavities by 6 months in 30.6% (15/49 patients) and sputum conversion in 46.9% (23/49 patients). Those parameters did not differ significantly from those in patients from Comparison Group (with HIV-negative status). Deterioration of spirometry results was recorded in 28.3±14.6% of patients in MG and 29.5±14.6% in CG, p>0.05; PCB remained at the preoperative level in both groups. A subgroup of 14 (28.6%) patients with limited (insufficient) effect after extrapleural thoracoplasty showed a significant decrease in the degree of dyspnea as well no significant changes in the spirometric values. Thus, extrapleural thoracoplasty can be considered functionally safe.