Current surgical therapy for patients with tuberculous abscess of the chest wall

Background. Although anti-tuberculosis medication is essential for the treatment of tuberculous abscess of the chest wall, surgical treatment also plays an important role. We report our surgical experience for patients with tuberculous abscess of the chest wall. Methods. The series was comprised of 16 patients with tuberculous abscess of the chest wall, and they were treated from May 1996 to June 2003 at St. Vincent's Hospital, Suwon, Korea. The data were retrospectively reviewed. Results. Tuberculous abscesses were managed by combined anti-tuberculosis medication and surgery of either abscess excision with rib resection (11 abscesses) or abscess excision alone (7 abscesses). The overall rate of rib involvement for abscess was 44.4% (8 abscesses in 7 patients), and the rate of rib involvement was not much different according to the extent of the chest wall involvement. The incidence of performing a second surgical procedure was higher in the following groups: (1) the group with pathologic evidence of bone involvement (3 of 7 patients vs 1 of 9 patients), (2) the group that was not given preoperative anti-tuberculosis medication (4 of 7 patients vs none of 9 patients). Conclusions. In managing tuberculous abscess of the chest wall, extensive abscess excision with rib resection is considered to be important. Preoperative anti-tuberculosis medication may play an important role in reducing the postoperative complication, including abscess recurrence.