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The main organs affected by the chronic infectious disease tuberculosis (TB) are the lungs. Although the main form
of therapy for TB is medicinal, surgical intervention may be necessary if the disease is localized to a particular
area of the lung and cannot be effectively treated with medicines alone. Segmentectomy, pneumonectomy, and
lobectomy are the three primary surgical procedures used to treat TB, and video-assisted thoracoscopic surgery, a
minimally invasive technique, enables the removal of the diseased tissue. The surgical removal of one of the five
lung lobes is known as a lobectomy. When TB is limited to one lobe of the lung and cannot be adequately treated
with medication alone, surgery is often undertaken. Candidates for lobectomy include patients with cavitary lesions
larger than 4 cm, a persistent cough, fever, hemoptysis, bronchopleural fistula, or localized abscess formation. The
risk of problems can be reduced with appropriate pre-operative assessment, surgical technique, and post-operative
care. The surgical removal of the complete lung is known as a pneumonectomy. It is normally saved for TB cases
where medicine is ineffective and the disease has spread to affect a significant area of the lung. Pneumonectomy
may be an option for patients who have severe cavitary lesions, extensive lung damage, considerable main
bronchus involvement, or consequences including bronchopleural fistula, severe hemoptysis, or localized abscess
formation. Similar to lobectomy, the risk of problems can be reduced with good pre-operative assessment, surgical
technique, and post-operative care. A segment of a lung lobe is surgically removed, a procedure known as a
segmentectomy or partial lobectomy. When TB is confined to a particular area of the lung and cannot be properly
treated with drugs alone, surgery may be an option. Segmentectomy may be beneficial for patients with a tiny
cavitary lesion, localized fibrosis, or a cavitary lesion that cannot be removed in the upper lobe of the lung or who
are unable to have more comprehensive surgery. Once more, minimizing the risk of problems can be achieved
through good pre-operative assessment, surgical technique, and post-operative care.
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