Role of thoracic surgery in patients suffering from Acquired Immune Deficiency Syndrome

Background and purpose: To study the role of thoracic surgery in patients s uffering from Acquired Immune Deficiency Syndrome (AIDS) in a South Bronx c ommunity with a high incidence of the disease. Methods: A retrospective ana lysis of medical records of patients who underwent thoracic surgery at Bron x-Lebanon hospital, New York, over a three year period between 1996-1998. R esults: The thoracic surgeons at Bronx-Lebanon Hospital in New York operate d upon a total of 210 patients. Of these, 39 were operated upon for AIDS-re lated illnesses, comprising 17% of the operative workload. The indications of surgery in these patients were variable, ranging from infections to tumo urs. Fifteen patients were operated on for pericardial effusion. Ten were o perated on for empyema, which had failed to resolve with thoracostomy alone and necessitated decortication. Tumours also formed a significant portion of the surgical workload. Three patients had Kaposi's sarcoma of the lung a nd three had a primary lymphoma in the lung. The mortality rate was high (4 6%). Conclusion: The data suggest that surgical intervention in AIDS-relate d chest diseases is unable to alter the course of the disease. Earlier dete ction and intervention of these complications may improve outcome in some p atients.