The Role of Resectional Surgery for the Treatment of Localized Multi-drug Resistant Pulmonary Tuberculosis.
10.4046/trd.2000.49.6.676
- Author:
Chang Hyeok AN
;
Jong Woon AHN
;
Kyeong Woo KANG
;
Soo Jung KANG
;
Young Hee LIM
;
Gee Young SUH
;
Man Pyo CHUNG
;
Ho Joong KIM
;
O Jung KWON
;
Chong H RHEE
- Publication Type:Original Article
- Keywords:
Multi-drug resistant pulmonary tuberculosis;
Surgery
- MeSH:
Follow-Up Studies;
Humans;
Isoniazid;
Lung;
Mortality;
Pneumonia;
Retrospective Studies;
Rifampin;
Sputum;
Tuberculosis, Pulmonary*
- From:Tuberculosis and Respiratory Diseases
2000;49(6):676-683
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Surgery may have a role when medical treatment alone is not successful in patients with multi-drug resistant (MDR) pulmonary tuberculosis (PTB). To document the role of resection in MDR PTB, we analyzed 4 years of our experience. METHODS: A retrospective review was performed on thirteen patients that underwent pulmonary resection for MDR PTB between May 1996 and February 2000. All patients had organisms resistant to many of the first-line drugs including isoniazid (INH) and rifampicin (RFP). RESULTS: The thirteen patients were 37.5±12.4 years old (mean±S.D.)(M:F=5:8), and their sputum was culture positive even with adequate medication for prolonged periods (109.7±132.0 months), resistant to 2-8 drugs including isoniazid and rifampin. All patients had localized lesion(s) and most (92.3%) had cavities. At least 3 sensitive anti-TB medications were started before surgery in all patients according to the drug sensitivity test. The preoperative FE1 was 2.37±0.83 L. Lobectomy was performed in 11 patients and pleuropneumonectomy in two. Postoperative mortality did not occur, but pneumonia occurred as a complication in one (7.7%). After 41.5±58.9 days (range 1~150 days) follow up, negative conversion of sputum culture was achieved in all patients within 5 months. Only one patient (7.7%) recurred 32 months after lung resection. CONCLUSION: When medical treatment alone is not successful, surgical resection can be a good treatment option in patients with localized MDR PTB.
