Extensive Lung Resection for Nontuberculous Mycobacterial Lung Disease With Multilobar Lesions

Area of Science:

• Thoracic Surgery
• Pulmonary Medicine
• Infectious Diseases

Background:

• Nontuberculous mycobacterial lung disease frequently affects multiple lung lobes.
• Extensive lung resection (ELR) is sometimes necessary for disease control.
• The safety and feasibility of ELR for this condition are not well-established.

Purpose of the Study:

• To compare the outcomes of extensive lung resection (ELR) versus simple anatomic lung resection (SALR) in patients with nontuberculous mycobacterial lung disease.
• To evaluate the safety and feasibility of ELR in this patient population.

Main Methods:

• Retrospective study of 146 patients with nontuberculous mycobacterial lung disease who underwent either ELR (n=54) or SALR (n=92).
• Comparison of patient characteristics and outcomes between the two surgical groups.
• Cox regression analysis was used to assess risk factors for unfavorable outcomes.

Main Results:

• ELR involved longer operative times and a higher incidence of prolonged air leak compared to SALR.
• No significant differences were observed in mortality, sputum culture conversion, or microbiological recurrence rates between ELR and SALR.
• Multivariate analysis indicated that ELR was not a significant risk factor for unfavorable outcomes.

Conclusions:

• Extensive lung resection (ELR) appears to be as safe and feasible as simple anatomic lung resection (SALR) for nontuberculous mycobacterial lung disease, despite some drawbacks.
• ELR may offer enhanced disease control for patients with multilobar nontuberculous mycobacterial lung disease.