Phthisiology

doi: 10.25005/2074-0581-2018-20-2-3-271-275
THE ROLE OF THE IMPLANTABLE PORT SYSTEM FOR THE CENTRAL VENOUS ACCESS IN TREATMENT OF PULMONARY TUBERCULOSIS WITH MULTIPLE AND EXTENSIVELY DRUG RESISTANCE (PRELIMINARY RESULTS)

О.R. Razakov1, R.R. Batirov1, R.G. Gaipov1, Zh. N. Yusupov2, M.D. Abdiev3

1Department of Pulmonary Tuberculosis Surgery, National Center for Phthisiology, Bishkek, Kyrgyz Republic
2Department of Anesthesiology and Resuscitation, National Center for Phthisiology, Bishkek, Kyrgyz Republic
3Department of Bones and Joints Tuberculosis Surgery, National Center for Phthisiology, Bishkek, Kyrgyz Republic

Objective: To study the role of the implantable port system (IPS) in the treatment of pulmonary tuberculosis with multiple and extensively drug resistance (MDR TB, XDR TB).

Methods: Since September 2017, IPS (POLYSITE 4008 ECHO) implanted in seven patients (4 men and 3 women) with MDR and XDR forms of pulmonary tuberculosis in the age of 30 to 60 years. All IPS implanted under the local anesthesia in the operation room. Port system installed with catheterization of the subclavian vein, mainly on the right. All these patients at the time of IPS installation received a short course of chemotherapy with new and before profiled preparations after having passed through a Consultation on drug-resistant tuberculosis.

Results: The use of IPS for patients with MDR TB and XDR TB pulmonary tuberculosis demonstrated a high level of commitment to treatment. Only in one case, the infection and suppuration of punction area took place in short-term period. This complication was corrected by secondary surgical treatment and overlay of secondary seams.

Conclusions: The preliminary results of the IPS application for seven patients with MDR TB and XDR TB demonstrated high safety and effectiveness of the technique, which allows recommending it, be for further expanded use in the treatment of this patients.

Keywords: Tuberculosis treatment, MDR TB, XDR TB, implantable port system.

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References
  1. Sadirova DS, Trubnikov AB, Mukhtarov DZ, Saidova ShM, Kalandarova LN. Prichiny vozniknoveniya i effektivnost’ lecheniya shirokoy lekarstvennoy ustoychivosti u bol’nykh tuberkulyozom lyogkikh [The causes and effectiveness of treatment of drug resistance in patients with pulmonary tuberculosis]. Molodoy uchyonyy. 2017;5:51-3.
  2. Toktogonova AA. Kharakteristika MLU TB sluchaev v zavisimosti ot ranee prinyatogo lecheniya na period 2005-2015 gody v Kyrgyzskoy Respublike [Characteristics of MDR TB cases, depending on the previ-ously accepted treatment for the period 2005-2015 in the Kyrgyz Republic]. Nauka, novye tekhnologii i innovatsii. 2017;8:37-9.
  3. Shilova MV, Khrulyova TS. Effektivnost’ lecheniya bol’nykh tuberkulyozom na sovremennom etape [The effectiveness of treatment of patients with tuberculosis at the present stage]. Problemy tuberkulyoza. 2010;3:3-11.
  4. Zinovyev IP, Pozdeeva NV, Belyaeva EL, Esaulova NA, Kokovikhina IA, Novikov VG. Pervichnaya lekarstvennaya ustoychivost’ mikobakteriy tuberkulyoza u bol’nykh s vpervye vyiyavlennym destruktivnym tuberkulyozom lyogkikh [Primary drug resistance of mycobacterium tuberculosis in patients with first detected destructive pulmonary tuberculosis]. Problemy tuberkulyoza i bolezney lyogkikh. 2009;4:37-9.
  5. Kobeleva GV, Kopylova IF, Bayborodova TI. Letal’nye iskhody ot tuberkulyoza v pervyy god posle vyiyavleniya [Lethal outcomes from tuberculosis in the first year after detection]. Tuberkulyoz i bolezni lyogkikh. 2011;8:41-3.
  6. Maryandyshev A. Mnozhestvennaya lekarstvennaya ustoychivost’ mikobakteriy tuberkulyoza [Multiple drug resistance of mycobacterium tuberculosis]. Meditsinskaya gazeta. 2009;17:8-9.
  7. Wolinsky ERA, Steenken WJr. Drug-resistant tubercle bacilli in patients under treatment with streptomycin. Am Rev Tuberc. 1948;58:335-43.
  8. Ahuja SD, Ashkin D, Avendano M, Banerjee R, Bauer M, Bayona JN, Chan ED. Multidrug resistant pulmonary tuberculosis treatment regimens and patient outcomes: an individual patient data meta-analysis of 9,153 patients. PLoS Medicine. 2012;9(8):e1001300. Available from: https://doi.org/10.1371/journal.pmed.1001300.
  9. Lange C, Abubakar I, Alffenaar JW. Management of patients with multidrug-resistant/extensively drug-resistant tuberculosis in Europe: A TBNET consensus statement. Eur Respir J. 2014;44:23-63.
  10. Jaganath D, Lamichhane G, Shah M. Carbapenems against mycobacterium tuberculosis: a review of the evidence. Int J Tuberc Lung Dis. 2016;20:1436-47.
  11. Wilson SE. Vascular access. Principles and practice. 5th ed. Philadelphia, USA: Lippincott Williams and Wilkins; 2010. 317 p.
  12. Mironenko TV, Tsigelnik AM, Mozes AD, Kosinova MV. Pervyy opyt implantatsii intravenoznoy port-sistemy dlya khimioterapii na baze Kemerovskoy oblastnoy klinicheskoy bol’nitsy [The first experience of intravenous port-system implantation for chemotherapy on the basis of the Kemerovo Regional Clinical Hospital]. Meditsina v Kuzbasse. 2014;4:56-8.
  13. Woodburn RT. Subcutaneous venous access device and needle system. USA Patent № 220609. 29.08.1989.
  14. Huber RR. Hypodermic needle. USA Patent № 654373. 22.10.1946.
  15. Rykov MYu, Dzampaev AZ, Buydenok YuV, Susuleva NA, Polyakov VG. Primenenie implantiruemykh venoznykh port-sistem v onkologii [Application of implantable venous port systems in oncology]. Onkologiya. 2014;3(4):38-44.
  16. Sofue K. Ultrasonography-guided central venous port placement with subclavian vein access in pediatric oncology patients. Journal of Pediatric Surgery. 2015;50:1707-10.

Authors informations:

Razakov Orunbay Razakovich, Candidate of Medical Sciences, Head of the Department of Pulmonary Tuberculosis Surgery, National Center for Phthisiology

Batirov Rakhmatilla Raimzhanovich, Surgeon in the Department of Pulmonary Tuberculosis Surgery, National Center for Phthisiology

Gaipov Rustam Gaipovich, Doctor of Medical Sciences, Professor, Leading Researcher, National Center for Phthisiology

Yusupov Zhaynak Nabievich, Head of the Department of Anesthesiology and Resuscitation, National Center of Phthisiology

Abdiev Marat Dzhumadylovich, Candidate of Medical Sciences, Deputy Director for Science, National Center for Phthisiology

Address for correspondence:

Batirov Rakhmatilla Raimzhanovich

Surgeon in the Department of Pulmonary Tuberculosis Surgery, National Center for Phthisiology

720020, Kyrgyz Republic, Bishkek, Akhunbaev str., 90a

Tel.: (+996) 312 570926

E-mail: rom312@list.ru

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