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The Lung Surgery for HIV-Positive Patients
PDPI Lampung & Bengkulu, 11 Mei 2019 07:51:27

Abstract

The aim of this study was to investigate the features of postoperative period, the risk of specific and nonspecific infections complications, to clarify the influence of surgical trauma on the course of HIV infections in immediate postoperative period.

Materials and methods: We examined the results of 146 surgical procerdures for HIV-positive patients. 32 patients underwent diagnostic surgery: for metastatic disease (14), mediastinal lymphoadenopathy (10), solitary pulmonary nodules (8). Diagnostic surgery was perfomed with negative screening results. 114 patients underwent surgical treatmant. Surgical indication in 91 cases was lung tuberculosis, 18 - lung cancer, 3 -aspergillosis, 2 - with cicatrical stenosis of the cervical trachea underwent tracheal resection. The main feature was B or C hepatitis in all cases. The structure of perfomed operation: VATS biopsy of mediastinal lymph nodes (10), VATS lung biopsy (14), VATS wedge resection (32), segmentectomy (32), lobectomy (36), pneumonectomy (23), cervical traheal resection (2).

Results: The postoperative complications - 23.3% (34 patients). Postoperative mortality - 1.4% (2 patients). Both of deceased patients underwent pneumonectomy due to progressive drug-resistant tuberculosis. The cases of death was due to intrapleural hemorrhage with subsequent development of multiple organ failure. The basis for planing lobectomy or pneumonectomy operetions was 200 CD4+ lymphcytes level and the VATS biopsy and wedge resections was in cases of 150 CD4+ m- cels or more. 75% patients has increased level of CD4+ lymphcytes after operation with reducing viral load.

Conclusion: Research has proven efficiency and safety of lung resection for HIV-positive patients with CD4+ lymphocytes level 150 or more.

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