Sublobectomy is a safe alternative for localized cavitary pulmonary tuberculosis

Area of Science:

• Thoracic surgery
• Infectious disease management
• Pulmonary medicine

Background:

• Surgical resection is crucial for treating pulmonary tuberculosis (PTB).
• Limited comparative data exists for lobectomy versus sublobectomy in PTB with cavities.
• Localized cavitary PTB requires careful surgical consideration.

Purpose of the Study:

• To compare the efficacy and safety of lobectomy and sublobectomy for localized cavitary PTB.
• To evaluate surgical complications, patient outcomes, and recovery characteristics.
• To determine the optimal surgical strategy for this patient population.

Main Methods:

• A single-institution cross-sectional cohort study.
• Inclusion of 203 patients undergoing either lobectomy or sublobectomy for localized cavitary PTB.
• Follow-up and comparison of surgical complications, outcomes, and patient characteristics.

Main Results:

• Both lobectomy and sublobectomy groups demonstrated similar long-term outcomes and low relapse rates after a follow-up of 13.1 ± 12.1 months.
• The sublobectomy group experienced significantly less intraoperative blood loss, shorter hospital stays, and fewer postoperative complications compared to the lobectomy group (P < 0.05).
• Postoperative medication duration was similar between groups, indicating comparable disease management post-surgery.

Conclusions:

• Both sublobectomy and lobectomy are effective surgical treatments for cavitary PTB when indicated.
• Sublobectomy is recommended when adequate anti-TB chemotherapy is ensured, due to greater preservation of lung parenchyma, faster recovery, and reduced postoperative complications.
• This finding supports a more conservative surgical approach for localized cavitary PTB, prioritizing lung function preservation.