Analysis of the effectiveness of two different surgical methods on treating cervical lymph node tuberculosis

doi:10.3969/j.issn.2096-8493.2021.01.007

Abstract

Abstract:

Objective To explore and analyze the effectiveness of two different surgical methods on treating cervical lymph node tuberculosis. Methods A total of 347 patients with cervical lymph node tuberculosis diagnosed bacteriologically or pathologically and treated by surgery in the Department of General Surgery of Heilongjiang Infectious Disease Hospital from January 2016 to January 2019 were retrospectively analyzed. Among them, 112 patients were treated with conventional debridement as the control group; 235 patients were treated with debridement combined with regional lymph node dissection as the study group. Cure rates, improvements of quality of life (QOL) scale, wound healing and complications of the two groups were analyzed. Results Cure rate of the study group (97.9%, 230/235) was significantly higher than that of the control group (84.8%, 95/112), the difference was statistically significant (χ²=6.14, P=0.029). Wound healing rate of grade A in the study group (90.6%, 213/235) was higher than that of the control group (63.4%, 71/112), the difference was statistically significant (χ²=4.71, P=0.018); the healing rates of grade B (8.5%, 20/235) and grade C (0.9%, 2/235) in the study group were lower than those of grade B (25.0%, 28/112) and grade C (11.6%, 13/112) in the control group, and those differences were statistically significant (χ²=5.16 and 4.43, P=0.032 and 0.028). Incidence of complications in the study group (5.1%, 12/235) was lower than that in the control group (17.9%, 20/112), the difference was statistically significant (χ²=4.17, P=0.012). After 3 months of anti-tuberculosis treatment, QOL score of the study group (52.83±2.19) was significantly higher than that of the control group (39.12±2.08), the difference was statistically significant (t=8.92, P=0.001). Conclusion Focus clearing combined with regional lymphadenectomy can effectively improve the postoperative healing rate, improve the rate of postoperative incision grade A healing, reduce the incidence of postoperative complications, and improve the quality of life of patients.

Key words: Tuberculosis, lymph node, Neck dissection, Lymph node excision, Comparative effectiveness research

ZHANG Zhe-nan, JIANG Nan-yang, WANG Wei, JIANG Lian-ju, LIU Yu-qin. Analysis of the effectiveness of two different surgical methods on treating cervical lymph node tuberculosis[J]. Journal of Tuberculosis and Lung Disease , 2021, 2(1): 26-30. doi: 10.3969/j.issn.2096-8493.2021.01.007

Figures/Tables 2

References 12

[1]	Fontanilla JM, Barnes A, von Reyn CF. Current diagnosis and management of peripheral tuberculous lymphadenitis. Clin Infect Dis, 2011,53(6):555-562. doi: 10.1093/cid/cir454. doi: 10.1093/cid/cir454 URL
[2]	Handa U, Mundi I, Mohan S. Nodal tuberculosis revisited: a review. J Infect Dev Ctries, 2012,6(1):6-12. doi: 10.3855/jidc.2090. doi: 10.3855/jidc.2090 URL pmid: 22240421
[3]	Baskota DK, Prasad P, Kumar Sinha B, et al. Distribution of lymphnodes in the neck in cases of tuberculous cervical lymphadenitis. Acta Otolaryngol, 2004,124(9):1095-1098. doi: 10.1080/00016480410018089. doi: 10.1080/00016480410018089 URL pmid: 15513556
[4]	Dahale AS, Kumar A, Srivastava S, et al. Esophageal tuberculosis: Uncommon of common. JGH Open, 2018,2(2):34-38. doi: 10.1002/jgh3.12043. doi: 10.1002/jgh3.12043 URL pmid: 30483561
[5]	Chahed H, Hachicha H, Berriche A, et al. Paradoxical reaction associated with cervical lymph node tuberculosis: predictive factors and therapeutic management. Int J Infect Dis, 2017,54:4-7. doi: 10.1016/j.ijid.2016.10.025. doi: 10.1016/j.ijid.2016.10.025 URL pmid: 27810522
[6]	徐尚胜, 秦世炳, 范俊, 等. 病灶清除植骨联合外固定治疗腕关节结核的疗效分析. 中国防痨杂志, 2019,41(12):1258-1262. doi: 10.3969/j.issn.1000-6621.2019.12.005.
[7]	Chikkannaiah P, Vani BR, Benachinmardi K, et al. Axillary lymph node tuberculosis masquerading as inflammatory breast carcinoma in an immune-compromised patient. Int J STD AIDS, 2016,27(2):149-151. doi: 10.1177/0956462415572838. doi: 10.1177/0956462415572838 URL pmid: 25681261
[8]	Moualed D, Robinson M, Qureishi A, et al. Cervical tuberculous lymphadenitis: diagnosis and demographics, a five-year case series in the UK. Ann R Coll Surg Engl, 2018,100(5):392-396. doi: 10.1308/rcsann.2018.0021. doi: 10.1308/rcsann.2018.0021 URL pmid: 29484929
[9]	Mulay SG, Hiranandani LH. A clinical study and the surgical man-agement of two hundred and fifty cases of tubercular cervical lymph-adenitis. J Laryngol Otol, 1970,84:781-794. doi: 10.1017/s0022215100072546. doi: 10.1017/s0022215100072546 URL pmid: 5452122
[10]	Kim BH, Jeon YJ, Jin YJ, et al. Conservative treatment for cutaneous fistula resulted from abscess formation in patients with tuberculous cervical lymphadenitis. Auris Nasus Larynx, 2018,45(5):1061-1065. doi: 10.1016/j.anl.2018.01.006. doi: 10.1016/j.anl.2018.01.006 URL pmid: 29402607
[11]	李忠万, 李劲松, 廖修富, 等. 颈部淋巴结核治疗的外科术式选择. 临床耳鼻咽喉头颈外科杂志, 2015,29(13):1190-1193. doi: 10.13201/j.issn.1001-1781.2015.13.013.
[12]	王直, 刘锦程, 李军孝, 等. 173例颈部淋巴结结核外科治疗效果的相关因素分析. 中国防痨杂志, 2016,38(7):559-563. doi: 10.3969/j.issn.1000-6621.2016.07.009.

[1]	ZHANG Zhi-guo, GUO Hai-ping, PANG Yu. Considerations for the application of laboratory diagnostics in detecting drug-resistant tuberculosis [J]. Journal of Tuberculosis and Lung Disease, 2021, 2(1): 13-17.
[2]	WANG Zhi-hui, DONG Ya-kun, CHI Yue-peng, DI Hong-qin, LIANG Ya-chong, XIE Lan-pin. Evaluation of the application value of fluorescence PCR probe melting curve method in detecting drug resistance in elderly pulmonary tuberculosis patients [J]. Journal of Tuberculosis and Lung Disease, 2021, 2(1): 18-22.
[3]	WANG Lian-bo, ZHANG Zhi-hua, LIU Feng-sheng, JIA Chen-guang, DONG Zhao-liang, YAO Xiao-wei, WU Shu-cai. Application value of GeneXpert MTB/RIF in diagnosis of joint tuberculosis and detection of rifampin resistance [J]. Journal of Tuberculosis and Lung Disease, 2021, 2(1): 23-25.
[4]	XIAO Juan, PI Hong-lin, SUN Qing-peng. Analysis of clinical characteristics and therapeutic effect of 96 patients with spinal tuberculosis underwent surgical treatment [J]. Journal of Tuberculosis and Lung Disease, 2021, 2(1): 38-42.
[5]	LI Yuan, GAO Feng-hua, JIN Feng. Evaluation of treatment and management effect of DOTS combined with WeChat on pulmonary tuberculosis patients [J]. Journal of Tuberculosis and Lung Disease, 2021, 2(1): 50-53.
[6]	FANG Lan-jun, WU Hui-zhong, HUANG Shan-shan, WEN Wen-pei, ZHOU Lin, CHEN Liang. Evaluation of intervention effect of WeChat health education on the knowledge, belief, and behavior of tuberculosis prevention and treatment in college freshmen [J]. Journal of Tuberculosis and Lung Disease, 2021, 2(1): 54-57.
[7]	SUN Ming-lei, GUAN Li, LIANG Li-bo, ZHAO Juan, WANG Chen, ZOU Dan-dan. Bibliometric analysis of tuberculosis patient and care system delay based on Web of Science core database [J]. Journal of Tuberculosis and Lung Disease, 2021, 2(1): 62-68.
[8]	JIAO Wei-wei. Advances in molecular diagnostic techniques of tuberculosis in children [J]. Journal of Tuberculosis and Lung Disease, 2021, 2(1): 69-72.
[9]	GUI Xu-wei, KE Hui, GU Jin. Progress of diagnostic research in biomarkers tuberculous pleurisy [J]. Journal of Tuberculosis and Lung Disease, 2021, 2(1): 73-77.
[10]	GUI Min, CHEN Jing-fang, DENG Guo-fang, FU Liang, ZENG Gu-qing. Research progress on the effectiveness and adverse reactions of clofazimine in the treatment of multidrug-resistant tuberculosis [J]. Journal of Tuberculosis and Lung Disease, 2021, 2(1): 78-82.
[11]	HAN Li-jun, ZHAO Xue-yao. Molecular detection technologies for diagnosing tuberculous meningitis using cerebrospinal fluid [J]. Journal of Tuberculosis and Lung Disease, 2021, 2(1): 8-12.
[12]	HAN Mei, HAN Pu, CHEN Ya-ting, YANG Song, YAN Xiao-feng. Study progress on the application of sputum induction in the etiological diagnosis of pulmonary tuberculosis [J]. Journal of Tuberculosis and Lung Disease, 2021, 2(1): 83-87.
[13]	ZHU Guo-feng, LIU Xiao-qing. The new era of systematic immunology of tuberculosis [J]. Journal of Tuberculosis and Lung Disease, 2020, 1(3): 195-212.
[14]	YI Jun-li, YANG Xin-yu, ZHANG Jie, TIAN Li-li, DING Bei-chuan, WU Wen-qing. Application evaluation of three methods for identification between Mycobacterium tuberculosis complex and non-tuberculous mycobacteria [J]. Journal of Tuberculosis and Lung Disease, 2020, 1(3): 240-244.
[15]	SU Bi-yi, ZHOU De-wang, MA Pin-yun, GUAN Ping, TAN Yao-ju. Diagnostic value of melting curve method in detecting resistance of Mycobacterium tuberculosis to rifampicin and isoniazid [J]. Journal of Tuberculosis and Lung Disease, 2020, 1(3): 245-248.