Pulmonary diseases caused by nontuberculous mycobacteria are increasingly becoming common worldwide and are occurring more frequently alongside pulmonary tuberculosis. Given that pulmonary diseases resulting from nontuberculous mycobacteria and pulmonary tuberculosis display similar features—such as clinical manifestations, imaging findings, and laboratory results—the accurate differentiation of each disease type is highly challenging. Mycobacterial culture, as a gold standard method, cannot be considered completely trustworthy because of low bacterioexcretion rates among nontuberculous mycobacterial pulmonary patients. Additional problems result from poor diagnosis. The treatment of lung diseases caused by nontuberculous mycobacteria is also difficult. This could be due to the wide spectrum of bacteria belonging to nontuberculous mycobacteria, as well as low bacterioexcretion. Therefore, bacterial sensitivity to drugs is insufficient. As a result, in this article, our intention is to explain the diagnostic difficulties of pulmonary diseases caused by nontuberculous mycobacteria and the Mycobacterium tuberculosis complex. The review seeks to outline promising directions for the development of novel diagnostic approaches in order to improve clinical decision-making and ultimately treatment outcomes.

The purpose of the study was to improve quality of surgical treatable of destructive pulmonary tuberculosis in patients with diabetes.Materials and methods. D.B. Giller and employees of the Department of Phthisiopulmonology and Thoracic Surgery of the First Moscow State Medical University M.I. Sechenov performed operations on 200 patients with diabetes due to tuberculosis. Group 1 was mustered from 78 patients from 2004 to 2009. Group 2 was mustered from 122 patients from 2011 to 2017.Results. An analysis of the results showed that after 31 operations, 27 (13.5%) patients from both groups developed 33 complications. The second group (6,6 %) had fewer complications after surgery than the first group (24,4%) 3.7 times. The first group had more vulnerary and bronchopleural complications than the second group. 12 patients (15,4%) of the first group and 6 patients (4,9%) of the second group had bronchopleural complications (empyema, residual cavity, delayed expansion of the lung and intrapleural bleeding). 2 patients died in the hospital (30-day mortality was 0.66%) after 303 surgical intervention in both groups. 1 patient (0.9%) died after 106 surgical intervention in the first group. 1 patient (0.5%) died after 197 surgical intervention in the second group. The full effect was achieved in 75 (96.2%) patients in the first group and 114 (93.4%) in the second group. The survival value of patients of the second group was 100% after 1 year, 98% after 2 years, 98.8% after 3 years, 96.9% after 4 years, 95.2% after 5 years. The surgical treatable affected the occupational rehabilitation of patients from group 2. 61.5% of patients from group 2 became able to work after 1 year. 64.5% of patients from group 2 became able to work after 5 years.Conclusion. If doctors will use our tactics in patients with destructive pulmonary tuberculosis and diabetes, the risk of complications after surgery dropped and reactivation of tuberculosis will not occur.

Objective. To increase efficiency of cavitary pulmonary tuberculosis treatment by developing modern indications and technology of extrapleural pneumolysis with filling material.Material and methods. We reviewed 25 patients with cavitary pulmonary tuberculosis and bacterial excretion who had undergone extrapleural pneumolysis with different types of filling material in 2004–2015. In 16 cases, we performed surgery in patients with one lung.Results. 56% of operated patients demonstrated extensively drug-resistant TB, 40% had multidrug-resistant TB. Cavities were closed and bacterial excretion ceased in 92% of patients at discharge. Long-term results with observation period from 1 to 12 years were analyzed in 24 patients, 17 (71%) of them had complete clinical efficacy.Conclusion. Extrapleural pneumolysis is a mini-invasive surgical treatment that can prove positive effect in patients with non-fibrotic changes in a cavity wall and pathological process in upper parts of the lungs.

Background: While non-specific pleural empyema in children can be successfully managed with conservative drainage and thoracentesis in 80–84% of cases, tuberculous pleural empyema (TB empyema) exhibits high resistance and frequently requires extensive thoracic surgery. The choice of surgical scope depends directly on disease stage and secondary complications. Methods: We conducted a retrospective cohort study of 85 pediatric patients (aged 4 to 17 years) with confirmed TB empyema treated between 1984 and 2022, and followed until 2025. Disease staging followed a predefined adaptation of the American Association for Thoracic Surgery (AATS) consensus classification. The study adhered strictly to STROBE guidelines, incorporating temporal stratification across three historical eras and standardized Clavien–Dindo complication reporting. This study describes a 38-year surgical experience at a tertiary pediatric phthisiosurgical center; non-operated patients successfully cured with exclusive chemotherapy were excluded. Results: Stage I empyema was identified in three patients, Stage II in seven, and Stage III in 75 patients (79 total procedures). Stage I–II patients underwent video-assisted thoracoscopic (VATS) debridement. In Stage III, advanced reconstructive interventions were required (39 VATS pleurectomies, 21 segmental resections, eight pleuropneumonectomies, six lobectomies, two thoracomyoplasties, two open resections, and one bronchus occlusion). Postoperative complications occurred in two patients (2.35% patient-level; categorized as Clavien–Dindo Grade IIIa and Grade IIIb), presenting as delayed lung re-expansion managed via secondary minor interventions. Overall 30-day postoperative mortality was 0.0%. Over a median follow-up of 48 months (database lock: 31 December 2025; 97.65% 36-month completeness), zero disease recurrences were documented (0.0%). Conclusion: In this tertiary surgical cohort, combined management incorporating stage-dependent surgical intervention achieved durable clinical cure. Early VATS debridement represents an effective option for Stage I–II patients who fail initial drainage, potentially reducing progression to a rigid fibrothorax and the subsequent need for extensive pulmonary resections.

Background: While non-specific pleural empyema in children can be successfully managed with minimally invasive drainage and pleural puncture in 85–90% of cases. Tuberculous pleural empyema (TB empyema) exhibits high clinical resistance and frequently requires extensive thoracic surgical interventions. The choice of surgical extent directly depends on the disease stage and the presence of complications. Methods: We conducted a retrospective analysis of diagnostic and surgical outcomes in 85 children and adolescents (aged 4 to 17 years) with tuberculous pleural empyema treated between 1984 and 2022. TB empyema staging was performed using the American Thoracic Society (ATS) classification was adapted for tuberculous etiology. Results: Stage I TB empyema was diagnosed in 3 patients, Stage II in 7 patients, and Stage III in 75 patients. Patients with Stage I and II disease underwent video-assisted thoracoscopic (VATS) debridement of the empyema cavity. In Stage III, 75 patients underwent 79 surgical interventions of varying extents. Postoperative complications occurred in 2 patients (2.5%). This occurred as delayed lung re-expansion, which was successfully managed with repeat thoracentesis in one patient and chest tube drainage in the other. The overall 30-day postoperative mortality rate was 0.0%. No recurrences were reported during the 3-year follow-up period.Conclusion: Comprehensive treatment combined with timely surgical intervention achieves clinical cure in all patients. Early minimally invasive VATS interventions during Stages I–II prevent the need for more traumatic procedures, such as pleurectomy and lung resection, which are often required in Stage III disease.