Current Surgical Intervention for Pulmonary Tuberculosis

Takeda, Shin‐ichi; Maeda, Hitoshi; Hayakawa, Masanobu; Sawabata, Noriyoshi; Maekura, Ryoji

doi:10.1016/j.athoracsur.2004.09.007

Cited by 73 publications

(46 citation statements)

References 20 publications

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“…Compared to previous studies of surgery, the present series of patients shows similar chest radiographic findings and a similar duration of therapy following surgery [12][13][14]. Previous studies report a longer duration of medical therapy before surgery, with medians ranging from 14 months to several years.…”

Section: Discussionsupporting

confidence: 50%

Adjunctive resectional lung surgery for extensively drug-resistant tuberculosis

Dravniece

Cain²,

Holtz³

et al. 2009

European Respiratory Journal

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Extensively drug-resistant (XDR) tuberculosis (TB) poses significant management challenges as there are limited pharmacological treatment options for cure. Adjunctive resectional lung surgery decreases case-fatality rates for some patients with multidrug-resistant tuberculosis (MDR-TB), but its use has not been well documented for patients with XDR-TB.We describe 17 XDR-TB patients treated with surgery as part of their case management in Latvia during 1999-2005. One patient had no previous TB treatment history, 10 were previously treated for drug-susceptible TB and six were previously treated for MDR-TB. Mycobacterium tuberculosis isolates from the 17 patients were resistant to a mean of 9.2 drugs. Due to failure of pharmacological therapy, one due to a large cavity and one due to pulmonary haemorrhage, 15 patients were treated with surgery. Despite failure of pharmacological treatment in 15 out of 17 patients, eight (47%) were cured with adjunctive surgical treatment. Surgery should be explored as a possible treatment option for patients with XDR-TB.

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Section: Discussionsupporting

confidence: 50%

Adjunctive resectional lung surgery for extensively drug-resistant tuberculosis

Dravniece

Cain²,

Holtz³

et al. 2009

European Respiratory Journal

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“…Thus, to cure the disease completely, it is imperative to resect the cavitary lesion and damaged lung tissue, leaving no grossly diseased lung behind. 3) In other retrospective studies, 3,9) early mortality is reported to be under 3%; though, in this study, it was 7.6% because of the death of one patient (on postoperative day 8) who had a vital capacity of less than 50% and a low FEV ı , which necessitated a pneumonectomy, resulting from laceration of the main pulmonary artery during the hilar dissection. Significant morbidity of the surgical treatment is reported to be about 20%-25%.…”

Section: -7)mentioning

confidence: 44%

“…Takeda noted that blood loss for tuberculosis surgery is threefold larger than that during lung cancer surgery. 9) Prolonged air leak and space problems developed in 1 patient during the post operative period. The air leak responded to tube drainage, and the space that had filled with serous fluid did not become infected.…”

Section: -7)mentioning

confidence: 99%

Surgery Offers High Cure Rates in Multidrug-resistant Tuberculosis

Yaldız

Gürsoy²,

Üçvet³

et al. 2011

ATCS

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Purpose: Drug resistance has become a major problem in the treatment of tuberculosis, and pulmonary resection in combination with chemotherapy appears to be an effective measure for the treatment. The purpose of this study was to investigate the results of resection for multidrug-resistant pulmonary tuberculosis (MDR-TB). Patients and Methods: We retrospectively reviewed case files from January 2003 to December 2006 of 13 patients with MDR-TB underwent pulmonary resection. Results: Of 13 patients, 7 (53.9%) were sputum positive for mycobacterium tuberculosis preoperatively, though after surgery, they were sputum negative. Lobectomy was performed in 8 (61.5%) and pneumonectomy, in 5 (38.5%). In the lobectomy group, 2 patients had an additional superior segmentectomy and 1 had a middle lobectomy for other segmental or lobar lesions. Operative mortality was 7.6% (1/13). There were no late surgical deaths. In the early postoperative period, 3 patients had serious complications (postoperative bleeding, prolonged air leak, expansion deficit, bronchopleural fistula and empyema) that were resolved with surgery (morbidity 23.0%). The 12 patients who survived the operation received appropriate chemotherapy and were followed up for 24-37 months. None of the patients relapsed, and the overall cure rate was 92.3% (12/13). Conclusion: Even with high morbidity in the early post-operative period, surgery, in addition to medical therapy, offers higher cure rates than only medical therapy; however, meticulous preoperative evaluation of patients is needed.

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“…Caminero [13] considers surgery when the patient meets the following conditions: a) localized lesions; b) adequate pulmonary functions; and c) lack of sufficiently available drugs to design a potent regimen. Lallo et al [14], Furak et al [23], Freixnet et al [24], Shirashi et al [25] and Takeda et al [26] have a broader range of indications for pulmonary surgery in this setting, including high profile resistance, multiple previous relapses, persistent sputum positivity despite four-six months of therapy, high risk of recurrence based on the presence of destroyed lung tissue and cavities, hemoptysis, and drug allergy.…”

Section: Figure 1 Radiological Findings Of Mdr-tb Patients See Detamentioning

confidence: 99%

Multidrug-resistant tuberculosis: case reports study in a central state of Brazil

Araújo-Filho¹,

Vasconcelos-Jr²,

Sousa³

et al. 2008

Braz J Infect Dis

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Multidrug-resistant tuberculosis (MDR-TB) is an emerging and worrisome health problem that threatens tuberculosis (TB) control worldwide. The clinical management of MDR-TB is a complex issue associated with the use of multiple drugs for a long period, usually accompanied by side effects and high costs. The objective of this work was to relate cases of MDR-TB occurring in Goiás, a central state of Brazil. We related five cases of MDR-TB, three women and two men. All were pulmonary cases. Three were in their second treatment and two in their first treatment. Surgical pulmonary resection was performed in one case. One death occurred. Lack of adherence, gastric intolerance to anti-TB drugs and poor clinical management were the main aspects related to the emergent resistance. A revision of the main clinical aspects of this disease was performed.

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Current Surgical Intervention for Pulmonary Tuberculosis

Cited by 73 publications

References 20 publications

Adjunctive resectional lung surgery for extensively drug-resistant tuberculosis

Adjunctive resectional lung surgery for extensively drug-resistant tuberculosis

Surgery Offers High Cure Rates in Multidrug-resistant Tuberculosis

Multidrug-resistant tuberculosis: case reports study in a central state of Brazil

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