Surgical treatment timing for multi-drug resistance tuberculosis patients: a retrospective study
10.3760/cma.j.issn.1001-4497.2014.03.004
- VernacularTitle:外科治疗耐多药肺结核的手术时机
- Author:
Pan ZHAO
;
Mingying JIANG
;
Yuzhong XIE
;
Xiaogang ZENG
- Publication Type:Journal Article
- Keywords:
Tuberculosis,pulmonary;
Lobectomy;
Drug therapy,combination;
Postoperative complications
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2014;30(3):141-144
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the optimal timing of surgical treatment for multi-drug resistance patients,discuss the clinical effect of surgery with chemotherapy treatment for muhi-drug resistant tuberculosis,and obtain more evidence for further optimizing surgical treatment strategy for such patients.Methods 100 cases who were multi-drug resistant and who received treatment in our hospital from July 2003 to June 2010 were included in this retrospective study.Among them,50 (observation group) received pulmonary lobectomy followed by anti-tuberculosis chemotherapy for 12 to 24 months,and the others (control group) only received anti-tuberculosis regimens although they had indications for pulmonary lobectomy.All patients in both groups were followed up for 12 to 24 months.Therapeutic effects and post-operational events were compared statistically in the observation group patients according to their duration of disease.Results Results At the end of follow-up,the cure rate,illness exacerbation rate and mortality were 36.0% (18/50),16.0% (8/50) and 26.0% (13/50) respectively in the control group,whereas those in the observation group were 80.0% (40/50),2.0% (1/50) and 4.0% (2/50) respectively.Resistanee to new anti-tuberculosis drugs appeared in 3 cases (6%) in the control group,while there was no new resistance in the observation group.The cure rate and complication rate were 96.30% and 3.70% respectively for patients whose duration of illness was less than 2 years,whereas those were 47.8% and 43.5% respectively for cases whose duration of illness was more than 2 years.Bronchopleural fistula,hemorrhage,pyothorax and pulmonary atelectasis were main postoperative complications,from which 11 cases recovered and 2 died,the death caused by choking of big haemoptysisand and multiple organs failure.Conclusion The therapeutic effects of surgical treatment plus anti-tuberculosis chemotherapy were better than chemotherapy alone.Pulmonary lobectomy could result in better response if done at the earlier stages of illness.Complications of operations were acceptable.