Surgical Management and Post operative Morbidity in Abdominal Tuberculosis Patients

Authors:
Perwira Widianto

Body of Abstract:
Background: The adequacy of tuberculosis treatment before abdominal surgery is a dilemma faced by surgeons who aims for low risk of morbidity. In addition, there is no morbidity data post abdominal operation in abdominal Tuberculosis (TB) patients at Persahabatan Central General Hospital.
Method: This study is a descriptive-analytic cross-sectional study done in Persahabatan Central General Hospital using total sampling method, a total of 110 subjects with abdominal TB and had undergone abdominal operation and was admitted from January 2019 to November 2024, that fulfilled the criteria of this study. Bivariate and multivariate analysis using SPSS was done to analyse the correlation between TB treatment adequacy and postoperative morbidity and mortality.
Results: 75 subjects (68%) did not receive adequate preoperative TB treatment. There are 2 significant morbidities in this study (fistula enterocutaneous, surgical site infection), only surgical site infection (SSI) has significant correlation with TB treatment adequacy (p=0.048). There is no significant correlation with postoperative mortality (p=0.564). Compared to elective surgery, emergency surgery has higher morbidity (OR = 1.62; 95% CI 0.58 – 4.53) and SSI (OR = 2.02; 95% CI 0.63 – 6.46)
incidence.
Conclusion: Adequate preoperative TB treatment lowers the postoperative morbidity such as surgical site infection. Morbidity and SSI are more likely to happen in emergency surgery than elective surgery. Both adequacy of antituberculosis treatment and surgery type are independent risk factors for morbidity. Anti-tuberculous therapy remains main stay of treatment after the surgery as early as possible surgical interference in acute abdominal tuberculosis is important to decrease the prevalence of morbidity and mortality in the patients.