Tuberculosis surgery

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Ammu Susheela, M.D. [2]


Surgery is indicated in certain conditions such as drainage of abscesses and empyema, ventricular shunt in tubercular meningitis, surgical resection of damaged tissues in abdominal tuberculosis, stabilization of the spine in case of Pott's disease ,pneumonectomy, lobectomy, pericardiocentesis or surgical repair of pericardium.


Pulmonary tuberculosis

Renal tuberculosis

Surgery is required to manage the urinary obstruction in genito-urinary tuberculosis. The three most common locations that may cause urinary obstruction is as follows. [2]

  • Pelvi-ureteral junction
  • Calyx
  • Lower end of the ureter
Types of surgery Proceedure
Cavernotomy It involves removal of the caeseous material leading to prevention of complications like abscess rupture. It has excellent prognosis
Partial nephrectomy This was an old technique to remove the affected tissue. Recently the drug therapy can help the calyx to heal, so partial nephrectomy is not widely done now.
Nephrectomy Chief indication of nephrectomy is obstruction of pelvi-ureteric junction. Plastic surgery of pelvi uretric junction is an alternative to it. Drianage improves the treatment
Excision of stricture then re implantation of ureter into the bladder. This is another conservative surgical procedure that has good prognosis.

Spinal tuberculosis

The cornerstone of treatment for skeletal tuberculosis is antibiotics and surgery. Surgical treatment of spinal tuberculosis of different stages are given below. [1]

Stage Treatment
Stage 1 (synovitis)
   Restriction of movements
Stage 2 (Early arthritis)
   Restriction of movements
Stage 3 (Advanced arthritis)
Stage 4 (Advanced arthritis)
Stage 5
   Osteotomybr>   Arthrodesis

Tuberculosis pericarditis

The treatment of choice is surgical removal or repair of infected sac of pericardium if it is not responsive to antibiotics. The available surgical procedures include: Open surgical removal and pericardiocentesis. Pericardiectomy is used for patients who deteriorate even after 4-8 weeks of anti tuberculous treatment. [3]

Tuberculosis meningitis

Surgical placement of shunt is used to drain the fluid and prevent the brain damage as a result of accumulation of fluid.

Abdominal tuberculosis

Surgical resection of intestine that is damaged by tuberculosis and not responding to anti tuberculous treatment can prevent the complications of abdominal tuberculosis


  1. 1.0 1.1 "Surgery tuberculosis" (PDF).
  2. HANLEY HG (1963). "TREATMENT OF RENAL TUBERCULOSIS". Br Med J. 2 (5373): 1611–2. PMC 1873944. PMID 14066180.
  3. Bozbuga N, Erentug V, Eren E, Erdogan HB, Kirali K, Antal A; et al. (2003). "Pericardiectomy for chronic constrictive tuberculous pericarditis: risks and predictors of survival". Tex Heart Inst J. 30 (3): 180–5. PMC 197314. PMID 12959199.

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