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[2 cases of pulmonary excision in patients with acquired immunodeficiency syndrome. What is the role of surgery in AIDS?].

The authors report two cases of lung resection in patients with AIDS: left upper lobectomy for diagnosis and treatment of an active, localized lung lesion which proved to be tuberculosis and atypical resection of the right apex and pleurodesis for an infected pneumohydrothorax. The postoperative course was uneventful despite the fragile clinical context. The place of surgical indications for diagnostic purposes is reduced by the good results obtained with endoscopic investigations and limited to failures of these procedures and to pulmonary sarcomatous lesions. The place of therapeutic surgical indications is essentially reserved for pleural complications (pleurodesis, pleurectomy, pleurotomy). Surgery may be unjustified in tracheostomised patients at the stage of respiratory failure. It may have a small but effective role with reduced risk in active, localized lung lesions. The surgery must be performed according to simple and classical by very rigorous rules of protection for the operators and the environment.