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 st ill 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 imm igrants (47%) was significantly higher than expected from their relati ve number. They also had a tendency to have more advanced or complicat ed forms of disease (61% vs 49% in local natives). As a probable conse quence of this, surgical resections were more aggressive in immigrants . The operative mortality was similar in both groups. This change of p resentation of lung tuberculosis is a new challenge to our local strat egy in treating this disease.