2010 Volume 24 Issue 2 Pages 134-139
Cold or tuberculous abscess of the chest wall is a rare entity. Although anti-tuberculosis chemotherapy is essential for the treatment of this disease, surgical treatment also plays an important role. We retrospectively reviewed 13 cases of tuberculous abscess of the chest wall that were surgically managed between January 2001 and September 2008 at Toneyama National hospital. We analyzed the surgical methods used, perioperative treatment, and results. The types of surgical treatment performed were as follows: complete excision and open drainage of the abscess followed by the implantation of chest wall muscles in 2 patients (15%), complete excision or debridement with the implantation of chest wall muscles in 5 patients (38%), complete excision or debridement without implantation in 5 patients (38%), and only abscess drainage in 1 patient (8%). Additional chest wall resection was performed in 9 patients (69%). Preoperative anti-tuberculosis chemotherapy was administered to 11 patients for more than 2 weeks. All patients were administered postoperative anti-tuberculosis chemotherapy for more than 6 months. In the mean follow-up period of 22.3 months, there was no recurrence of the abscess in 10 patients (75%). Thus, we recommend complete resection of the abscess along with the resection of a portion of the infected chest wall and a perioperative anti-tuberculosis chemotherapy regimen. We consider that these treatments reduce the postoperative recurrence of tuberculous abscess.
