Comparison of Outcome Between Anti-Tubercular Therapy Alone and Selective Neck Dissection Followed by Anti-Tubercular Therapy in Retreatment Cases of Tubercular Cervical Lymphadenopathy
Abstract
Background: Tubercular cervical lymphadenopathy (TCL) is a common form of extrapulmonary tuberculosis (EPTB), frequently presenting with painless cervical lymph node swelling. Treatment primarily involves anti-tubercular therapy (ATT), but in cases of relapse or treatment failure, the addition of surgical intervention may enhance outcomes. This study aims to compare the outcomes of ATT alone versus a combination of selective neck dissection (SND) followed by ATT in retreatment cases of tubercular cervical lymphadenopathy.
Methods: A single-blind, randomized controlled trial was conducted at Dhaka Medical College Hospital from January 2022 to July 2023. A total of 48 patients with retreatment cases of TCL were randomly assigned to either Group A (SND + ATT) or Group B (ATT alone). Data were collected on demographic characteristics, clinical presentation, lymph node involvement, diagnostic methods, and treatment outcomes. Patients were followed up every two months for six months to assess treatment efficacy.
Results: The study found no significant differences in demographic characteristics between the groups. In terms of treatment outcomes, Group A showed a significantly higher cure rate (95.83%) compared to Group B (75.0%) (p = 0.043). Recurrence of disease was significantly lower in Group A (4.16%) than in Group B (25.0%) (p = 0.042). Complication rates were similar between the groups (Group A: 4.16%, Group B: 12.5%), with no significant difference (p = 0.300).
Conclusion: The addition of Selective Neck Dissection to Anti-Tubercular Therapy in retreatment cases of tubercular cervical lymphadenopathy significantly improves cure rates and reduces recurrence without increasing complications. These findings suggest that surgical intervention may be beneficial for patients with TCL who fail or relapse with medical therapy alone.
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References
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