Clinico-bacteriological analysis for video-assisted thoracoscopic biopsy of non-tuberculous mycobacteria

The prevalence of non-tuberculous mycobacteria (NTM) has been increasing in recent years, and thus the number of related surgeries. In recent studies, a few recent studies reported that NTM patients require preoperative treatment. In addition, some cases are found to be granuloma suspected to be NTM (gsNTM) after surgery. We conducted a clinico-bacteriological examination of resected NTM and gsNTM cases we managed.

Between 2003 and 2017, 82 patients with NTM and gsNTM underwent video-assisted thoracoscopic (VATS) biopsy at our institution. The objectives of surgery, perioperative treatment, progression of NTM and gsNTM, and bacteriological data were analyzed.

We enrolled 42 men and 40 women with a median age of 65 years. The bacteriological findings were Mycobacterium avium in 38 cases, M. intracellulare in 6 cases, M. kansasii in 3 cases, and gsNTM in 35 cases. The objectives of surgery were the diagnosis in 77 cases, and resistance to treatment in 6 cases. We performed postoperative treatment in 8 cases. There was no surgery-related (30-day mortality) death or complication.

We analyzed surgical outcome for pulmonary NTM infections. We need to reconsider the surgical procedure for single pulmonary NTM lesion and whether adjuvant chemotherapy is necessary for NTM treatment.