Surgical Treatment of Tuberculous Abscess in the Chest Wall

Background We reviewed surgical cases of tuberculous abscess in the chest wall and analyzed the indications and methods of surgery, results, perioperative complications, and postoperative treatment. Methods We retrospectively reviewed the records of 13 patients who underwent surgical treatment of tuberculous abscess in the chest wall between January 1994 and December 2003 at National Hospital Organization Tokyo Hospital. Results There was a past history of tuberculosis in 3 patients, concomitant active pulmonary tuberculosis in 5, concomitant active tuberculosis in the neck lymph node in 1, and no antecedent tuberculosis in 4. The locations of the tuberculous abscesses were right chest wall in 8 patients, left chest wall in 3, and anterior chest wall in 2. All of the patients underwent surgical treatment. In all patients, postoperative antituberculous treatments were administered. The combination regimens consisted of isoniazid (400 mg/d), rifampicin (450 mg/d), ethambutol (750 mg/d), pyrazinamide (1,500 mg/d), or some combination of these, and the duration ranged more than 6 months. Postoperative complications were not seen, and there was no recurrence. Conclusions We recommend a complete resection of the abscess with rib resection, and postoperative treatment by tuberculous chemotherapy regimen. We consider that these treatments reduce postoperative recurrence.