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Related Experiment Videos

Lung resection for multidrug-resistant tuberculosis.

Rishen Naidoo1, Anu Reddi

  • 1Cardiothoracic Surgery, Inkosi Albert Luthuli Central Hospital, Mayville, South Africa. rishendran@mweb.co.za

Asian Cardiovascular & Thoracic Annals
|May 21, 2005
PubMed
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Surgical lung resection offers a high cure rate for multidrug-resistant tuberculosis (MDR-TB) when medical therapy fails. This approach provides a viable option for carefully selected patients with localized disease or persistent positive sputum.

Area of Science:

  • Pulmonary Medicine
  • Thoracic Surgery
  • Infectious Diseases

Background:

  • Multidrug-resistant tuberculosis (MDR-TB) presents a significant global health challenge.
  • High relapse rates (up to 50%) after standard and second-line chemotherapy necessitate alternative treatment strategies.
  • Surgical intervention is being re-evaluated for MDR-TB management.

Purpose of the Study:

  • To evaluate the efficacy and safety of pulmonary resection in patients with MDR-TB.
  • To assess surgical outcomes, including mortality, morbidity, and cure rates.
  • To identify patient selection criteria for successful surgical intervention in MDR-TB.

Main Methods:

  • A retrospective review of 23 patients undergoing lung resection (17 pneumonectomy, 6 lobectomy) for MDR-TB.

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  • Patients had completed standard chemotherapy and at least 3 months of second-line therapy.
  • Follow-up included clinical assessment, sputum analysis, and monitoring for 18 months.

    • Main Results:

    • No operative or postoperative mortality was observed.
    • Major complications occurred in 17.4% of patients (empyema, bleeding requiring rethoracotomy).
    • Preoperative sputum positivity in 10 patients reduced to 1 postoperatively, with an overall cure rate of 95.6%.

    Conclusions:

    • Pulmonary resection is an effective adjunct to medical therapy for carefully selected MDR-TB patients.
    • Ideal candidates include those with localized disease, adequate pulmonary reserve, multiple relapses, or persistent positive sputum despite medical treatment.
    • Surgery provides high cure rates with acceptable morbidity and mortality for MDR-TB.