Effective anti-tuberculosis treatment for 4 – 8 weeks, the symptoms of toxicity improve, blood sedimentation decreases, has formed limited abscess caseous necrotic lesions as well as bone and joint tuberculosis destruction of dead bone to form peripheral abscesses, etc., non-surgical TB conditions that cannot be controlled or cured, in order to cure TB as early as possible, shorten the course of treatment, patients who need to implement surgical intervention, according to the size of surgery, CD4+ preferably above 200.
If CD4T lymphocytes below 200, no other serious comorbidities, non-emergency situations, limited lesions with surgical intervention, anti-tuberculosis treatment 3-4 months surgery, before and after surgery should be intensive anti-tuberculosis treatment, especially in patients with a long history of disease, second-line drugs to prevent the possibility of multi-drug resistance.
Objectives Removal of the lesion; functional reconstruction; retention of the specimen for culture of the tuberculosis bacilli plus drug sensitivity.
Recommendations Move the lesion out of the body as completely as possible with the least possible damage.
Abscess chest – drainage, contouring, or pleurodesis, with minimal pleuropneumonectomy.
Spinal tuberculosis – lesion debridement with minimal internal fixation.
Lymphatic tuberculosis – lesion debridement or drainage with minimal debridement.