[Pulmonary Tuberculosis--Is Surgery still Necessary?].

Area of Science:

• Pulmonology
• Infectious Diseases
• Surgical Oncology

Context:

• Tuberculosis (TB) remains a significant global health challenge, exacerbated by multidrug resistance (MDR-TB).
• Immigration and refugee populations contribute to the presence of TB in Europe.
• The rise of MDR-TB necessitates reevaluation of treatment strategies, including surgical interventions.

Purpose:

• To review the current indications for surgical intervention in the management of tuberculosis.
• To emphasize the role of surgery within a multimodal and interdisciplinary treatment framework for MDR-TB.
• To highlight the importance of antibiotic therapy in conjunction with surgical procedures.

Summary:

• Surgical intervention is indicated for specific complications of tuberculosis, including massive hemoptysis, aspergilloma, chronic hemoptysis, pneumothorax, bronchopleural fistula, and destroyed lung.
• For multidrug-resistant tuberculosis (MDR-TB), surgery is considered as part of an interdisciplinary and multimodal treatment approach.
• Effective antibiotic therapy, administered before and after surgery, is essential for sustained treatment success in all cases.

Impact:

• Surgical management, when integrated into a comprehensive treatment plan, can improve outcomes for patients with complicated or drug-resistant tuberculosis.
• This approach underscores the need for collaborative decision-making among specialists to optimize patient care.
• The findings support the continued role of surgery in managing severe and refractory tuberculosis cases.