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Surgical treatment of tuberculous cold abscess of the chest wall

 Hyo Chae Paik  ;  Kyung Young Chung  ;  Jeong Han Kang  ;  Dae Hyeon Maeng 
 YONSEI MEDICAL JOURNAL, Vol.43(3) : 309-314, 2002 
Journal Title
Issue Date
Abscess/drug therapy ; Abscess/surgery* ; Adolescent ; Adult ; Aged ; Antitubercular Agents/therapeutic use ; Child ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Thoracic Diseases/drug therapy ; Thoracic Diseases/surgery* ; Thoracic Surgical Procedures* ; Thoracic Vertebrae/surgery ; Tuberculosis/drug therapy ; Tuberculosis/surgery*
The incidence of tuberculosis (Tbc) infection is high in some parts of the world and tuberculous cold abscess of the chest wall (CACW) often fails to respond to medical treatment. Medical records of 178 patients who underwent surgical treatment of chest wall abscesses from July 1970 to Sept. 2000 were reviewed and 89 patients who were pathologically confirmed as Tbc cold abscess cases were included in this study. Their ages ranged from 9 to 71 years (mean 33.3 years) and the male to female ratio was 1.2:1 (49 male, 40 female). The symptoms were palpable chest wall mass, pain and pus discharge, and three patients had multiple lesions. Twenty-five patients (28%) underwent excision of chest wall abscesses and 64 patients (72%) underwent chest wall and rib resection. Tbc medication was given preoperatively in 39 patients for an average of 6.3 months and all patients were given Tbc medication postoperatively for an average of 12 months. Postoperative complications were bleeding, pus discharge, empyema, pleural effusion, wound dehiscence, subcutaneous emphysema and activation of pulmonary Tbc. The disease recurred in 7 patients (7.8%) and these 7 patients all underwent a second operation. We recommend preoperative Tbc medication and complete resection of chest wall abscesses including any suspicious ribs. Postoperative Tbc medication for a minimum of 12 months is essential to decrease the risk of a relapse.
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1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
Yonsei Authors
Paik, Hyo Chae(백효채) ORCID logo https://orcid.org/0000-0001-9309-8235
Chung, Kyung Young(정경영)
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