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Completion pneumonectomy for chronic mycobacterial disease
J Timothy Sherwood1, John D Mitchell, Marvin Pomerantz
1University of Colorado Health Sciences Center, Denver, Colo, USA.
The Journal of Thoracic and Cardiovascular Surgery
|June 9, 2005
Summary
Completion pneumonectomy offers a viable treatment for persistent mycobacterial lung infections when other therapies fail. This multidisciplinary approach, though risky, yields positive outcomes in most long-term survivors.
Area of Science:
- Pulmonary Medicine
- Infectious Diseases
- Thoracic Surgery
Background:
- Persistent pulmonary mycobacterial infections pose significant challenges due to patient comorbidities and limited treatment guidelines.
- Completion pneumonectomy is explored as a therapeutic option for recurrent or refractory mycobacterial lung disease.
Purpose of the Study:
- To evaluate the efficacy and outcomes of completion pneumonectomy in patients with persistent mycobacterial lung disease.
Main Methods:
- A 9-year retrospective study of 26 patients undergoing completion pneumonectomy for mycobacterial disease.
- Patients received intensive preoperative antibiotics, nutritional support, and surgical resection.
- Postoperative care involved a multidisciplinary approach with continued medical and nutritional therapy.
Main Results:
- Mycobacterium avium complex was the most common pathogen (n=15).
- Operative mortality was 23%, with significant morbidity in 46% of patients.
- Sputum conversion or medication cessation was achieved in 82% of long-term survivors.
Conclusions:
- Completion pneumonectomy is a critical treatment option for mycobacterial lung disease refractory to prior therapies.
- Despite significant risks, a structured multidisciplinary approach improves successful outcomes.
- Careful patient selection and postoperative management are crucial for favorable results.