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Updated: May 16, 2026
23:06
The MODS method for diagnosis of tuberculosis and multidrug resistant tuberculosis
Published on: August 11, 2008
Surgical interventions for drug-resistant tuberculosis: a systematic review and meta-analysis
M T Marrone1, V Venkataramanan, M Goodman
1Centers for Disease Control and Prevention, Division of Tuberculosis Elimination, Atlanta, GA 30333, USA.
Summary
Surgery shows promise for treating drug-resistant tuberculosis (DR-TB). Meta-analyses indicate surgical interventions are linked to successful treatment outcomes in multidrug-resistant TB (MDR-TB) and extensively drug-resistant TB (XDR-TB) patients.
Area of Science:
- Pulmonary Medicine
- Infectious Diseases
- Surgical Oncology
Background:
- The rise of multidrug-resistant tuberculosis (MDR-TB) and extensively drug-resistant tuberculosis (XDR-TB) necessitates re-evaluating treatment strategies.
- Surgical interventions are regaining consideration as a viable option for drug-resistant TB (DR-TB).
Purpose of the Study:
- To systematically review and assess the existing literature on the effectiveness of surgical interventions in treating drug-resistant TB.
- To synthesize evidence from comparative and single-arm studies on surgical outcomes in DR-TB patients.
Main Methods:
- Comprehensive literature search of Medline, EMBASE, and PubMed (1975-2012), supplemented by hand searching.
- Inclusion of studies comparing surgical and non-surgical treatments for MDR-TB and XDR-TB.
- Meta-analyses using random effects models to evaluate treatment outcomes based on internationally accepted definitions.
Main Results:
- Meta-analysis of 24 studies revealed a significant association between surgery and successful treatment of DR-TB (OR 2.24).
- 23 single-arm studies showed high rates of successful short-term (92%) and long-term (87%) outcomes in surgical patients.
- Favorable surgical outcomes correlated with increased drug resistance levels.
Conclusions:
- Surgical intervention appears associated with successful treatment outcomes in DR-TB.
- Insufficient evidence exists to recommend surgery over chemotherapy alone or to determine optimal surgical conditions.
- Further controlled studies are required to definitively assess surgical effectiveness and associated risks in DR-TB management.
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