Pulmonary resection for multi–drug resistant tuberculosis

Abstract

Surgery remains an important adjunct to medical therapy for the treatment of multi-drug resistant Mycobacterium tuberculosis. In the setting of localized disease, persistent sputum positivity, or patient intolerance of medical therapy, pulmonary resection should be undertaken. Pulmonary resection for multi-drug resistant tuberculosis can be performed with acceptable operative morbidity and mortality.

Cirugía en tuberculosis pulmonar multirresistente.

“…Actualmente, algunos proponen para el tratamiento de la tuberculosis multirresistente la cirugía de resección pulmonar asociada con un tratamiento farmacológico adecuado, como una alternativa importante para el control de esta patología (19)(20)(21). Esto parece comprobarse en el presente estudio, en el cual de 28 pacientes multirresistentes a los medicamentos antituberculosos, 22 (78,5%) continuaron con baciloscopia negativa durante el tiempo de seguimiento posterior a la cirugía.…”

“…Con respecto al tratamiento antituberculoso posterior a la cirugía, se ha descrito la necesidad de suministrarlo entre 12 y 18 meses (11,20,25); en nuestro estudio, la duración promedio fue de 12,5 meses.…”

Changing Trend of Surgery in Pulmonary Tuberculosis

“…However, surgery is also not without risks, some of which are i) Morbidity and mortality related to surgery, ii) Potential long-term functional deficits, iii)Transmission in the health facility etc. [2,3,9,10]. The probability of ultimate success depends on several factors: (I) proper & adequate antibiotic therapy; (II) compliance of the patient ; (III) effective multidisciplinary teamwork; (IV) experience in carrying out "not-routine surgical procedures"; and finally (V) ability to keep the patient hospitalized for a long time.…”

An experience of single lung resection and pneumonectomy after contralateral lung resection in treatment of tuberculosis

“…Из 30 описанных в литературе частичных резек-ций единственного легкого [1,5,13,23,25,27,28,30,37,43,45,46] в 24 была выполнена верхняя лоб-эктомия справа, в 2 -средняя лобэктомия справа, в 2 -верхняя лобэктомия справа с резекцией VI сег-мента, в 1 -нижняя лобэктомия справа и в 1 -нижняя лобэктомия слева.…”